Individual
JESSICA ELAINE LIGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Mailing address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(693) 211-7052
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301088493
MI
207ND0900X
Dermatopathology Physician
4301088493
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619179710
—
MI
01
—
4301088493
STATE LICENSE
MI
Enumeration date
06/01/2007
Last updated
01/31/2023
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