Provider Demographics
NPI:1780670877
Name:LIGGETT, ROBERT ERIC (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERIC
Last Name:LIGGETT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-3202
Mailing Address - Country:US
Mailing Address - Phone:740-474-6039
Mailing Address - Fax:740-477-2928
Practice Address - Street 1:401 N COURT ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-3202
Practice Address - Country:US
Practice Address - Phone:740-474-6039
Practice Address - Fax:740-477-2928
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4472/T1128152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0937928Medicaid
LI0746853Medicare ID - Type Unspecified
U44203Medicare UPIN