Provider Demographics
NPI:1467943555
Name:KLUSTY-LIGGETT, ARIEL R (DO)
Entity type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:R
Last Name:KLUSTY-LIGGETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4040 EMBASSY PKWY STE 370
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8372
Mailing Address - Country:US
Mailing Address - Phone:234-466-8618
Mailing Address - Fax:234-466-8502
Practice Address - Street 1:4040 EMBASSY PKWY STE 370
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-8372
Practice Address - Country:US
Practice Address - Phone:234-466-8618
Practice Address - Fax:234-466-8502
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016054207P00000X
390200000X
OH58.032067390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine