Provider Demographics
NPI:1164454518
Name:RIGGS, DEBRA A (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:RIGGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-936-5211
Practice Address - Street 1:2701 N ROCKWELL AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-5246
Practice Address - Country:US
Practice Address - Phone:405-789-4150
Practice Address - Fax:405-787-7920
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12760207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100145750BMedicaid
OK19561OtherOBNDD
OK12760OtherLICENSE
OK246721503Medicare PIN
OK12760OtherLICENSE