Provider Demographics
NPI:1689628125
Name:LIGGITT, PATRICK TODD (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:TODD
Last Name:LIGGITT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50060
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-5060
Mailing Address - Country:US
Mailing Address - Phone:405-843-2066
Mailing Address - Fax:405-843-2077
Practice Address - Street 1:2825 PARKLAWN DR
Practice Address - Street 2:SURGERY DEPARTMENT
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4201
Practice Address - Country:US
Practice Address - Phone:405-559-3535
Practice Address - Fax:405-843-2077
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0055518367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered