Provider Demographics
NPI:1154366896
Name:GRIGGS, LEAH RAE (MD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:RAE
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-781-5111
Mailing Address - Fax:270-780-0475
Practice Address - Street 1:484 GOLDEN AUTUMN WAY STE 201
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-6913
Practice Address - Country:US
Practice Address - Phone:270-781-5111
Practice Address - Fax:270-780-0475
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43634207RG0100X, 207RG0100X
KYTP127207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100118050Medicaid
KY000000658807OtherANTHEM
KY000000658807OtherANTHEM