MEDICARE: MR. MICHAEL OLEN RIGGS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	14786	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942304241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL OLEN RIGGS M.D.

Provider Business Mailing Address
First Line	:	13901 MCAULEY BLVD.
Second Line	:	STE. 210
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-8705
Country	:	US
Telephone Number	:	405-608-8828
Fax Number	:	405-608-1914

Provider Business Practice Location Address
First Line	:	13901 MCAULEY BLVD.
Second Line	:	STE. 210
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-8705
Country	:	US
Telephone Number	:	405-608-8828
Fax Number	:	405-608-1914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	12/19/2016

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