Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | E-1861 | AR |
N | 2080P0204X | Pediatric Emergency Doctor | E-1861 | AR |
NPI | 1265529317 |
---|---|
Provider Name | Rebecca Liggin |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 29/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5K894 | BCBS (01) | |
71604624206 | QUALCHOICE (01) | |
G74704 | (02) | |
P00020486 | RAILROAD MEDICARE2 (01) |