Provider Demographics
NPI:1144388042
Name:RIGGS, PAULA (MCD)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:RIGGS
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 COUNTY ROAD 774
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-0122
Mailing Address - Country:US
Mailing Address - Phone:870-931-6769
Mailing Address - Fax:
Practice Address - Street 1:2208 FOWLER AVE STE C
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6187
Practice Address - Country:US
Practice Address - Phone:870-931-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR846235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U734OtherBLUE CROSS & BLUE SHIELD
AR127005721Medicaid