Provider Demographics
NPI:1851604169
Name:RIGGSBEE, JOSHUA ADAM (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ADAM
Last Name:RIGGSBEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 HARDEN STREET EXT
Mailing Address - Street 2:15 MEDICAL PARK, SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6894
Mailing Address - Country:US
Mailing Address - Phone:803-545-5017
Mailing Address - Fax:803-255-3451
Practice Address - Street 1:3209 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6930
Practice Address - Country:US
Practice Address - Phone:803-434-6113
Practice Address - Fax:803-434-7231
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC014175Medicaid
SC1417OtherMEDICAL LICENSE
SCSC80282353Medicare PIN
SCSC80282353Medicare PIN