Healthcare Provider Details

I. General information

NPI: 1295980589
Provider Name (Legal Business Name): JOSEPH MICHAEL WRIGHT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 LORENA LN
BIRMINGHAM AL
35213
US

IV. Provider business mailing address

117 LORENA LN
BIRMINGHAM AL
35213-2527
US

V. Phone/Fax

Practice location:
  • Phone: 205-296-2049
  • Fax:
Mailing address:
  • Phone: 205-296-2049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number080260
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: