Provider Demographics
NPI:1821171810
Name:RIGGS, JAMES LESTER (R PH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LESTER
Last Name:RIGGS
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:MR
Other - First Name:SONNY
Other - Middle Name:L
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R PH
Mailing Address - Street 1:17 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-5315
Mailing Address - Country:US
Mailing Address - Phone:912-764-5613
Mailing Address - Fax:
Practice Address - Street 1:17 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-5315
Practice Address - Country:US
Practice Address - Phone:912-764-5613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist