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General NPI Number Information
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NPI Number | 1225657539
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Entity Type | Individual
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Provider Name | JOSEPH W LIGGETT JR.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 202 S PARK ST
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City | MADISON
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State | WI
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Zip | 53715-1507
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Country | US
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Telephone | 608-417-6993
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Fax |
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Provider Business Mailing Address
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Address Line | 2752 ALICE CIR
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City | STOUGHTON
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State | WI
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Zip | 53589-3353
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Country | US
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Telephone | 608-877-2607
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 122977-30
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License Number State | WI
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