MEDICARE: DR. B CODY WRIGHT MD

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	2084P0800X	Psychiatry Physician	33927	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33927	OTHER	AZ	AZ LICENSE

General Provider Information

NPI Number	:	1194728451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. B CODY WRIGHT MD

Provider Business Mailing Address
First Line	:	177 SAWTOOTH OAK ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-7160
Country	:	US
Telephone Number	:	501-520-6353
Fax Number	:

Provider Business Practice Location Address
First Line	:	177 SAWTOOTH OAK ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-7160
Country	:	US
Telephone Number	:	501-520-6353
Fax Number	:

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	03/07/2023

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