Basic Information
| Provider Information | |||||||||
| NPI: | 1104081744 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KEITH D RIGSBY, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4105 GREENWOOD WAY | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760635563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143342190 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4105 GREENWOOD WAY | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760635563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143342190 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2008 | ||||||||
| LastUpdateDate: | 11/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | RIGSBY | ||||||||
| AuthorizedOfficialFirstName: | KEITH | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2143342190 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.