=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184892564
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EARL L. DRIGGS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2008
-----------------------------------------------------
Last Update Date | 02/20/2008
-----------------------------------------------------
=====================================================
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 |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 75 HOSPITAL DR SUITE 340
-----------------------------------------------------
City | ATHENS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45701-2857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-592-5799
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. EARL LEE DRIGGS
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 740-592-5799
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 36-00-2856
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------