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General NPI Number Information
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NPI Number | 1255767703
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Entity Type | Organization
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Legal Business Name | HILTON HEAD MACULA & RETINA, PA
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 15 LAFAYETTE PL SUITE A
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City | HILTON HEAD
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State | SC
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Zip | 29926-2276
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Country | US
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Telephone | 843-422-9987
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Fax |
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Provider Business Mailing Address
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Address Line | 15 LAFAYETTE PL SUITE A
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City | HILTON HEAD
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State | SC
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Zip | 29926-2276
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Country | US
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Telephone | 843-442-9987
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER E. LIGGETT
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Credential | MD
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Telephone | 843-442-9987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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