Provider Demographics
NPI:1043242027
Name:LIGGINS, TONI JOHNSON (MD)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:JOHNSON
Last Name:LIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 NORTH MEADOWS DRIVE
Mailing Address - Street 2:GME 5TH FLOOR BLDG 2
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123
Mailing Address - Country:US
Mailing Address - Phone:216-410-4693
Mailing Address - Fax:
Practice Address - Street 1:5300 NORTH MEADOWS DRIVE
Practice Address - Street 2:GME FLOOR BUILDING 2
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123
Practice Address - Country:US
Practice Address - Phone:614-663-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0667412084P0800X
NC2013-018472084P0800X
OH350667412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2030126Medicaid
NC1043242027Medicaid
NC180Y7OtherBCBSNC
NC180Y7OtherBCBSNC
OHJO7284971Medicare ID - Type Unspecified
NC1043242027Medicaid