Healthcare Provider Details

I. General information

NPI: 1881013712
Provider Name (Legal Business Name): ELIZABETH RIGGLE GARGARO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH ANNE RIGGLE MD

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S KOMAS DR STE 208
SALT LAKE CITY UT
84108
US

IV. Provider business mailing address

650 S KOMAS DR STE 208
SALT LAKE CITY UT
84108-1215
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-3936
  • Fax: 801-959-9096
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9538390-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number9538390-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9538390-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: