Basic Information
| Provider Information | |||||||||
| NPI: | 1821250648 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JEFFREY K RIGGS DO LLC | ||||||||
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| OtherOrganizationName: | RIGGS PHYSICIAN ASSISTANT GROUP | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1102 S VIRGINIA ST | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422403579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708857300 | ||||||||
| FaxNumber: | 2708857198 | ||||||||
| Practice Location | |||||||||
| Address1: | 1102 S VIRGINIA ST | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422403579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708857300 | ||||||||
| FaxNumber: | 2708857198 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2008 | ||||||||
| LastUpdateDate: | 07/02/2008 | ||||||||
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| AuthorizedOfficialLastName: | RIGGS | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2708857300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.