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General NPI Number Information
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NPI Number | 1144524596
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Entity Type | Organization
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Legal Business Name | EDWARD E. RIGDON, M.D., INC.
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 348 CROSSGATES BLVD SUITE 2500
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City | BRANDON
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State | MS
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Zip | 39042-2700
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Country | US
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Telephone | 601-825-1975
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Fax | 601-825-4127
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Provider Business Mailing Address
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Address Line | PO BOX 6019
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City | BRANDON
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State | MS
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Zip | 39047-3919
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Country | US
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Telephone | 601-825-1975
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Fax | 601-825-4127
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD E RIGDON
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Credential | M.D.
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Telephone | 601-825-1975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 08412
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License Number State | MS
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