Provider Demographics
NPI:1376914945
Name:ERIK H. RIEGER M.D., P.C.
Entity Type:Organization
Organization Name:ERIK H. RIEGER M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-345-3115
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81215-0469
Mailing Address - Country:US
Mailing Address - Phone:719-345-3115
Mailing Address - Fax:719-345-3331
Practice Address - Street 1:1335 PHAY AVE STE D
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2349
Practice Address - Country:US
Practice Address - Phone:719-345-3115
Practice Address - Fax:719-345-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96281375Medicaid
COCO304179Medicare Oscar/Certification