Healthcare Provider Details

I. General information

NPI: 1760696645
Provider Name (Legal Business Name): MILTON WRIGHT, D.O., PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13825 N 7TH ST STE A
PHOENIX AZ
85022-4342
US

IV. Provider business mailing address

13825 N 7TH ST STE A
PHOENIX AZ
85022-4342
US

V. Phone/Fax

Practice location:
  • Phone: 623-444-7974
  • Fax:
Mailing address:
  • Phone: 623-444-7974
  • Fax: 602-938-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4166
License Number StateAZ

VIII. Authorized Official

Name: DR. MILTON JACOB WRIGHT
Title or Position: OWNER
Credential: D.O.
Phone: 623-444-7972