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NPI Code Detail

MEDICARE: RONNY ERIC WRIGHT JR. PSYD

MEDICARE: RONNY ERIC WRIGHT JR. PSYD
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
1103T00000XPsychologist2793NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11305JOTHERNCBCBS OF NC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730171109
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONNY ERIC WRIGHT JR. PSYD
Provider Business Mailing Address
First Line : PO BOX 16310
Second Line :
City : WILMINGTON
State : NC
Zip : 28408-6310
Country : US
Telephone Number : 910-742-9243
Fax Number : 888-746-1787
Provider Business Practice Location Address
First Line : 5617 MAXWELL PL
Second Line :
City : WILMINGTON
State : NC
Zip : 28409-2966
Country : US
Telephone Number : 910-742-9243
Fax Number : 888-746-1787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 12/16/2013

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