Individual
DR. ELIZABETH GAULT LIGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
725 W MARKET ST, BOLIVAR, TN 38008
(731) 658-5197
(731) 658-5197
Mailing address
725 W MARKET ST, BOLIVAR, TN 38008-2242
(731) 658-5197
(731) 658-5245
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3199
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48082-001
DAVIS VISION
TN
01
—
6051220
BCBSTN
TN
01
—
7699658
CIGNA
TN
01
—
A22476
EYEMED
TN
05
—
Q01027
—
TN
Enumeration date
09/17/2014
Last updated
11/21/2019
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