Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4098 | SD |
NPI | 1003843624 |
---|---|
Provider Name | Richard Briggs |
First Address | Sioux Falls, SD 57118-6430 |
Second Address | Brandon, SD 57005-1426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 03/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5602093 | (05) | SD |