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NPI Code Detail

MEDICARE: DR. EDWARD THORBURN WRIGHT M.D.

MEDICARE:  DR. EDWARD THORBURN 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
1208800000XUrology Physician96-00428NC
2208800000XUrology Physician0101248303VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P0086324OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1414539OTHERVAANTHEM
31164428140OTHERVACIGNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164428140
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD THORBURN WRIGHT M.D.
Provider Business Mailing Address
First Line : 1040 MAIN ST
Second Line :
City : DANVILLE
State : VA
Zip : 24541-1816
Country : US
Telephone Number : 434-792-1433
Fax Number : 434-797-2807
Provider Business Practice Location Address
First Line : 1040 MAIN ST
Second Line :
City : DANVILLE
State : VA
Zip : 24541-1816
Country : US
Telephone Number : 434-792-1433
Fax Number : 434-797-2807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 07/10/2012

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Directions to “ DR. EDWARD THORBURN WRIGHT M.D.” Practice Location

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