Basic Information
| Provider Information | |||||||||
| NPI: | 1962473538 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGGS | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 W 18TH ST | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422401961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707072100 | ||||||||
| FaxNumber: | 2707072103 | ||||||||
| Practice Location | |||||||||
| Address1: | 231 BURLEY AVE | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422408725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708857300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 207RG0100X | 02496 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 000000052117 | 01 | KY | BCBS | OTHER | 64024961 | 05 | KY | MEDICAID |