Provider Demographics
NPI:1942304241
Name:RIGGS, MICHAEL OLEN (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:OLEN
Last Name:RIGGS
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 1:13901 MCAULEY BLVD.
Mailing Address - Street 2:STE. 210
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-8705
Mailing Address - Country:US
Mailing Address - Phone:405-608-8828
Mailing Address - Fax:405-608-1914
Practice Address - Street 1:13901 MCAULEY BLVD.
Practice Address - Street 2:STE. 210
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-8705
Practice Address - Country:US
Practice Address - Phone:405-608-8828
Practice Address - Fax:405-608-1914
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK147862086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100145740AMedicaid
OKE11814Medicare UPIN
E11814Medicare UPIN