Provider Demographics
NPI:1255767703
Name:HILTON HEAD MACULA & RETINA, PA
Entity type:Organization
Organization Name:HILTON HEAD MACULA & RETINA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-442-9987
Mailing Address - Street 1:15 LAFAYETTE PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2276
Mailing Address - Country:US
Mailing Address - Phone:843-442-9987
Mailing Address - Fax:
Practice Address - Street 1:15 LAFAYETTE PL
Practice Address - Street 2:SUITE A
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2276
Practice Address - Country:US
Practice Address - Phone:843-422-9987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty