Provider Demographics
NPI:1952359622
Name:RIGSBY, KEITH DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:DOUGLAS
Last Name:RIGSBY
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 1:601 S CLAY ST STE 104
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-5771
Mailing Address - Country:US
Mailing Address - Phone:972-875-6600
Mailing Address - Fax:877-460-4501
Practice Address - Street 1:601 S CLAY ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-5771
Practice Address - Country:US
Practice Address - Phone:972-875-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183589403Medicaid
TX8W7175OtherBCBS
TX183589401Medicaid
TX8K2330Medicare PIN
TX8K9320Medicare PIN
TX42167YXG8Medicare PIN
TX270858ZLFHMedicare PIN
TX270858YVLPMedicare PIN
TX8G6018Medicare PIN
TX8W7175OtherBCBS
TX8F6170Medicare PIN
TXI53390Medicare UPIN
TXP00319549Medicare PIN