Provider Demographics
NPI:1841374428
Name:JEFFREY K. RIGGS, D.O., PLLC
Entity type:Organization
Organization Name:JEFFREY K. RIGGS, D.O., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-885-7300
Mailing Address - Street 1:1102 S VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-3579
Mailing Address - Country:US
Mailing Address - Phone:270-885-7300
Mailing Address - Fax:270-885-7198
Practice Address - Street 1:1102 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3579
Practice Address - Country:US
Practice Address - Phone:270-885-7300
Practice Address - Fax:270-885-7198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02496207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100016560Medicaid
KY00486Medicare PIN