Healthcare Provider Details

I. General information

NPI: 1396775326
Provider Name (Legal Business Name): PETER E LIGGETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 LAFAYETTE PLACE SUITE A
HILTON HEAD SC
29926-2277
US

IV. Provider business mailing address

65 OUTPOST LN
HILTON HEAD SC
29928-3822
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-2020
  • Fax: 203-288-2470
Mailing address:
  • Phone: 203-980-0612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number36165
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207WX0108X
TaxonomyUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
License Number36165
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number36165
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: