Healthcare Provider Details

I. General information

NPI: 1891797437
Provider Name (Legal Business Name): DAVID C WRIGLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 PROVIDENCE DR SUITE 213
ANCHORAGE AK
99508-4616
US

IV. Provider business mailing address

PO BOX 241889
ANCHORAGE AK
99524-1889
US

V. Phone/Fax

Practice location:
  • Phone: 907-743-0740
  • Fax: 907-743-0741
Mailing address:
  • Phone: 907-563-1777
  • Fax: 907-561-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberAK4130
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: