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NPI Code Detail

MEDICARE: JOE WRIGHT CRNA

MEDICARE: JOE WRIGHT CRNA
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
1367500000XCertified Registered Nurse AnesthetistR32806AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
259537OTHERARBLUE CROSS OF AR

General Provider Information

NPI Number : 1164496469
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOE WRIGHT CRNA
Provider Business Mailing Address
First Line : 2729 S HIGHWAY 65 82
Second Line :
City : LAKE VILLAGE
State : AR
Zip : 71653-6136
Country : US
Telephone Number : 870-265-5351
Fax Number : 870-265-9306
Provider Business Practice Location Address
First Line : 2729 S HIGHWAY 65 82
Second Line :
City : LAKE VILLAGE
State : AR
Zip : 71653-6136
Country : US
Telephone Number : 870-265-5351
Fax Number : 870-265-9306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 03/18/2011

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