Provider Demographics
NPI:1013600071
Name:LIGON, CAROL RIGGS
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:RIGGS
Last Name:LIGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4425
Mailing Address - Country:US
Mailing Address - Phone:443-875-9811
Mailing Address - Fax:
Practice Address - Street 1:200 E JOPPA RD STE 207
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-3107
Practice Address - Country:US
Practice Address - Phone:410-296-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
MDUO2899171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist