Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101049629 | VA |
Y | 208600000X | Surgeon | 0101049629 | VA |
N | 2086S0102X | Surgical Critical Care | 0101049629 | VA |
NPI | 1336147719 |
---|---|
Provider Name | Dr. Jeffrey Lynn Riblet |
First Address | Portsmouth, VA 23707-3213 |
Second Address | Portsmouth, VA 23707-3213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 21/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007314001 | (05) | VA |
15979 | OPTIMA (01) | VA |
463390 | ANTHEM (01) | VA |
890692 | MEDICARE RR (01) | VA |
F60318 | (02) | VA |