Healthcare Provider Details

I. General information

NPI: 1093978207
Provider Name (Legal Business Name): MILTON WRIGHT DO PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13825 N 7TH ST. SUITE A
PHOENIX AZ
85022
US

IV. Provider business mailing address

13825 NORTH 7TH STREET SUITE A
PHOENIX AZ
85022
US

V. Phone/Fax

Practice location:
  • Phone: 623-444-7972
  • Fax: 602-938-5135
Mailing address:
  • Phone: 623-444-7972
  • Fax: 602-938-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number4166
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number4166
License Number StateAZ

VIII. Authorized Official

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