Provider Demographics
NPI:1285686865
Name:RIGGINS, JIMMIE WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:WAYNE
Last Name:RIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1726 METROMEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3861
Mailing Address - Country:US
Mailing Address - Phone:910-484-2284
Mailing Address - Fax:910-484-1673
Practice Address - Street 1:1726 METROMEDICAL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3861
Practice Address - Country:US
Practice Address - Phone:910-484-2284
Practice Address - Fax:910-484-1673
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9801752207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891209GMedicaid
NC891209GMedicaid
NC2263104AMedicare ID - Type Unspecified