Provider Demographics
NPI:1659376879
Name:RIFFE, KATHRYN A (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:A
Last Name:RIFFE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:200 HOSPITAL DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-3328
Mailing Address - Country:US
Mailing Address - Phone:731-855-1040
Mailing Address - Fax:731-855-3927
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:SUITE 402
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3328
Practice Address - Country:US
Practice Address - Phone:731-855-1040
Practice Address - Fax:731-855-3927
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM373213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4294853OtherBLUECROSS OF TENNESSEE
TN1790981066OtherMEDICARE GROUP NPI
TN1790981066OtherMEDICARE GROUP NPI
TNT92436Medicare UPIN