1437190956 NPI number — RONALD L WRIGHT MD

Table of content: RONALD L WRIGHT MD (NPI 1437190956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437190956 NPI number — RONALD L WRIGHT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
RONALD
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437190956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 GORDON GUTMANN BLVD
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
JEFFERSONVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47130-3766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-451-5855
Provider Business Mailing Address Fax Number:
502-479-1409

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 W 13TH STREET
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
JEFFERSONVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-282-6114
Provider Business Practice Location Address Fax Number:
812-282-6340
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X , with the licence number:  01057564B , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207V00000X , with the licence number: 37845 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200455860 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3691820000 . This is a "PASSPORT ADVTG - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000594680 . This is a "ANTHEM - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00533085 . This is a "MEDICARE - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000023034V . This is a "HUMANA - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64074974 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100588 . This is a "SIHO - WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50021526 . This is a "PASSPORT -WS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com