Basic Information
| Provider Information | |||||||||
| NPI: | 1801012042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGGAN | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | EUGENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 353 NEW SHACKLE ISLAND RD | ||||||||
| Address2: | SUITE 341-C | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370752379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158261716 | ||||||||
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| Practice Location | |||||||||
| Address1: | 353 NEW SHACKLE ISLAND RD | ||||||||
| Address2: | STE- 341C | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370752379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158261716 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 42989 | TN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1514794 | 05 | TN | MEDICAID |