Provider Demographics
NPI:1063415883
Name:DRIGGS, GUY KENNETH (MD)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:KENNETH
Last Name:DRIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-0580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5920 FOREST PARK RD
Practice Address - Street 2:STE 530
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6413
Practice Address - Country:US
Practice Address - Phone:972-991-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4306207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD48252Medicare UPIN