Healthcare Provider Details
I. General information
NPI: 1700285574
Provider Name (Legal Business Name): CARA WRIGHT MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2014
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2926 W HUNTSVILLE AVE
SPRINGDALE AR
72762-7726
US
IV. Provider business mailing address
2964 W HUNTSVILLE AVE
SPRINGDALE AR
72762-7726
US
V. Phone/Fax
- Phone: 479-717-1171
- Fax: 866-756-3200
- Phone: 479-717-1171
- Fax: 866-756-3200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | E-1700 |
| License Number State | AR |
VIII. Authorized Official
Name:
LESLIE
ALEXANDER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 479-439-8157