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NPI Code Detail

MEDICARE: MR. KENNETH J WRIGHT M.D.,

MEDICARE:  MR. KENNETH J 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
12086S0129XVascular Surgery Physician29517AL
22086S0129XVascular Surgery PhysicianME105164FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME15684OTHERFLLICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568410579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KENNETH J WRIGHT M.D.,
Provider Business Mailing Address
First Line : 2809 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-1852
Country : US
Telephone Number : 813-348-9088
Fax Number : 813-348-9310
Provider Business Practice Location Address
First Line : 2809 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-1852
Country : US
Telephone Number : 813-348-9088
Fax Number : 813-348-9310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 03/08/2011

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Directions to “ MR. KENNETH J WRIGHT M.D.,” Practice Location

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