Provider Demographics
NPI:1508851635
Name:RIGBY, DWIGHT A (MD)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:A
Last Name:RIGBY
Suffix:
Gender:M
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:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-387-3400
Mailing Address - Fax:801-387-3420
Practice Address - Street 1:4403 HARRISON BLVD
Practice Address - Street 2:STE 3400
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3271
Practice Address - Country:US
Practice Address - Phone:801-387-3400
Practice Address - Fax:801-387-3420
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT165314-1205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT25-00434OtherUNITED HEALTHCARE
UTPR00930Medicaid
UT20498551300106465Medicaid
UT3379936OtherCIGNA
UTQM0000016781OtherALTIUS
ID807609800Medicaid
IDDURB1OtherBC OF IDAHO
UT20498551384403A004OtherTRICARE
UT204985513DAROtherEMIA
UT20832OtherDMBA
UT90218OtherPEHP
UT107006021105OtherSELECTHEALTH
UT611697900OtherUSDOL
UT25-00434OtherUNITED HEALTHCARE
UT20498551384403A004OtherTRICARE
UTPR00930Medicaid