Douglas Wister Ligon, M.D.
Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Erin, TN
NPI 1376579730 · NPPES record last updated Jan 25, 2017
Key facts
- NPI
- 1376579730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- License
- MD6383 (TN)
- Practice address
- 4895 East Main St
Ste a
Erin, TN 37061 - Phone
- (931) 289-2929
- Fax
- (931) 289-2930
- NPI assigned
- Jun 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD6383 | TN | MD | Emergency Medical Services (Emergency Medicine) Physician |
| 6383 | TN | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omnipoint Surgical Associates LLC | Past | Accepting new patients | |
| Trinity Hospital LLC | Past | Accepting new patients | |
| Centennial Heart LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/9865/brand/1/csg/21/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | MD6383 | TN | Yes |
Addresses
Primary practice location
4895 East Main St
Ste a
Erin, TN 37061
Mailing address
PO Box 268
Erin, TN 37061-0268
Phone (931) 289-2929
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810676663 | Other | TN | TAX IDENTIFACTION |
| MD0000006383 | Other | TN | MEDICAL LICENSE NUMBER |
| P00282547 | Other | TN | RAILROAD MEDICARE |
| 3148023 | Medicaid | TN | |
| 4113788 | Other | TN | BCBS/TENNCARE SELECT |
Other providers in Erin, TN
- Olivia Hutcheson
- John L Stanton MD
- Leann Johnson
- Rebecca Astarita King
- Nichole Grice Lamberth
- Sonya Moseley Looney
- LP Erin LLC
- Cameron Rye Lyle
- Ginger C. Lyle
- Danny Maness
All providers in Erin, TN · Emergency Medical Services (Emergency Medicine) Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.