MEDICARE: GARTH BRADFORD WRIGHT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD0000031796	TN
2	207X00000X	Orthopaedic Surgery Physician	26776	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154392983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARTH BRADFORD WRIGHT M.D.

Provider Business Mailing Address
First Line	:	912 SOMERSET BLVD
Second Line	:	STE 101
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-3952
Country	:	US
Telephone Number	:	304-725-2663
Fax Number	:	304-724-0053

Provider Business Practice Location Address
First Line	:	912 SOMERSET BLVD
Second Line	:	STE 101
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-3952
Country	:	US
Telephone Number	:	304-725-2663
Fax Number	:	304-724-0053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	04/06/2022

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