Provider Demographics
NPI:1467520478
Name:GRIGGS, RHETT J (MD)
Entity Type:Individual
Prefix:DR
First Name:RHETT
Middle Name:J
Last Name:GRIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1875
Mailing Address - Street 2:433 SIXTH STREET
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-1875
Mailing Address - Country:US
Mailing Address - Phone:970-964-8472
Mailing Address - Fax:855-395-5972
Practice Address - Street 1:433 SIXTH STREET
Practice Address - Street 2:
Practice Address - City:CRESTED BUTTE
Practice Address - State:CO
Practice Address - Zip Code:81230-2243
Practice Address - Country:US
Practice Address - Phone:970-964-8472
Practice Address - Fax:855-395-5972
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNONE RESIDENT207X00000X
CODR-46388207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17674867Medicaid
CO17674867Medicaid