Healthcare Provider Details

I. General information

NPI: 1669468963
Provider Name (Legal Business Name): DRS. LIGGETT, ROCKLIN & LIGGETT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N COURT ST
CIRCLEVILLE OH
43113-3202
US

IV. Provider business mailing address

401 N COURT ST
CIRCLEVILLE OH
43113-3202
US

V. Phone/Fax

Practice location:
  • Phone: 740-474-6039
  • Fax: 740-477-2928
Mailing address:
  • Phone: 740-474-6039
  • Fax: 740-477-2928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES J. ROCKLIN
Title or Position: TREASURER
Credential: O.D.
Phone: 740-474-6039