MEDICARE: ROBERT L 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
1	367500000X	Certified Registered Nurse Anesthetist	1027758	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	430052321	OTHER	KY	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000051230	OTHER	KY	ANTHEM BCBS PIN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750352712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L WRIGHT CRNA

Provider Business Mailing Address
First Line	:	1020 N MAIN ST
Second Line	:
City	:	BEAVER DAM
State	:	KY
Zip	:	42320-1553
Country	:	US
Telephone Number	:	270-274-0480
Fax Number	:	270-274-0482

Provider Business Practice Location Address
First Line	:	1211 MAIN ST
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1619
Country	:	US
Telephone Number	:	270-298-7411
Fax Number	:	270-274-0482

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	08/28/2018

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Directions to “ ROBERT L WRIGHT CRNA” Practice Location

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