=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659376879
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHRYN A RIFFE D.P.M.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2005
-----------------------------------------------------
Last Update Date | 05/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 HOSPITAL DR SUITE 402
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38382-3328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-855-1040
-----------------------------------------------------
Fax | 731-855-3927
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 HOSPITAL DR SUITE 402
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38382-3328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-855-1040
-----------------------------------------------------
Fax | 731-855-3927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213EP1101X
-----------------------------------------------------
Taxonomy Name | Primary Podiatric Medicine Podiatrist
-----------------------------------------------------
License Number | DPM373
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213ES0131X
-----------------------------------------------------
Taxonomy Name | Foot Surgery Podiatrist
-----------------------------------------------------
License Number | DPM373
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------