MEDICARE: PAUL ERIC 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
1	207Q00000X	Family Medicine Physician	19618	OK

General Provider Information

NPI Number	:	1770572612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL ERIC WRIGHT M.D.

Provider Business Mailing Address
First Line	:	608 NW 9TH ST
Second Line	:	SUITE 1000
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 NW 9TH ST
Second Line	:	SUITE 1000
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1068
Country	:	US
Telephone Number	:	405-272-7494
Fax Number	:

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	10/20/2020

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