1932193034 NPI number — DR. RALPH J WRIGHT III MD

Table of content: DR. RALPH J WRIGHT III MD (NPI 1932193034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932193034 NPI number — DR. RALPH J WRIGHT III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
RALPH
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
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:
1932193034
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7951 E MAPLEWOOD AVE STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111-4726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-930-7800
Provider Business Mailing Address Fax Number:
303-930-7860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11750 W 2ND PL
Provider Second Line Business Practice Location Address:
#SUITE 150
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80228-1573
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-763-4020
Provider Business Practice Location Address Fax Number:
303-763-4039
Provider Enumeration Date:
09/02/2005

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: 2085R0001X , with the licence number:  35063013 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: 33578 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: 49811 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 56536356 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64869282 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100375680 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0870446 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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