Provider Demographics
NPI:1992859896
Name:RIGACCI, VICTOR ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ROBERT
Last Name:RIGACCI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 BRANDON DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9516
Mailing Address - Country:US
Mailing Address - Phone:859-586-2558
Mailing Address - Fax:
Practice Address - Street 1:2220 GRANDVIEW DRIVE STE 120
Practice Address - Street 2:
Practice Address - City:FT. MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-1403
Practice Address - Country:US
Practice Address - Phone:859-578-0393
Practice Address - Fax:859-815-8896
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1430DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY11-3652238Medicare UPIN