Organization
REMLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD RIGDON M.D. (RADIOLOGIST)
(309) 833-4101
Entity
Organization
Contact information
Practice address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-4101
Mailing address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-4101
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05532020
BLUE CROSS GROUP SHIELD
IL
Enumeration date
03/07/2007
Last updated
08/22/2020
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