=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033109418
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EARL L DRIGGS DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2005
-----------------------------------------------------
Last Update Date | 12/16/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 75 HOSPITAL DR SUITE 340
-----------------------------------------------------
City | ATHENS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45701-2857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-592-5799
-----------------------------------------------------
Fax | 740-594-8925
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5450 FRANTZ RD STE 360
-----------------------------------------------------
City | DUBLIN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43016-4141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-544-6155
-----------------------------------------------------
Fax | 614-544-6370
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 36-00-2856
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 36-00-2856
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------