Provider Demographics
NPI:1316126006
Name:J.H. RIGSBY III, M.D. LLC
Entity type:Organization
Organization Name:J.H. RIGSBY III, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:H
Authorized Official - Last Name:RIGSBY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:309-343-6000
Mailing Address - Street 1:834 N SEMINARY ST
Mailing Address - Street 2:STE 103
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2852
Mailing Address - Country:US
Mailing Address - Phone:309-343-6000
Mailing Address - Fax:309-343-9999
Practice Address - Street 1:834 N SEMINARY ST
Practice Address - Street 2:STE 103
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2852
Practice Address - Country:US
Practice Address - Phone:309-343-6000
Practice Address - Fax:309-343-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070094207W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDG5554OtherRR MEDICARE
ILDG5554OtherRR MEDICARE