Individual ProviderLee RigdonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5001 Hardy St, Hattiesburg, MS 39402-1308(601) 268-8000(601) 520-8080PECOS EnrollmentBased on the most recent information from CMS, provider Lee Rigdon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1497124432Provider TypeIndividualFull NameRigdon, LeeCredentialFNP-CGenderMaleSole ProprietorNoEnumeration Date9/21/2015Last Updated10/9/2020Contact InformationPractice LocationPractice Address5001 Hardy St, Hattiesburg, MS 39402-1308Phone(601) 268-8000FaxUnlisted FaxMailing LocationMailing Address6 Canebrake Blvd, Hattiesburg, MS 39402-8701Phone(601) 520-8080FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR861245Mississippi