Healthcare Provider Details

I. General information

NPI: 1194918201
Provider Name (Legal Business Name): ROY R WRIGHT M D LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

850 E HARVARD AVE 225
DENVER CO
80210-5073
US

IV. Provider business mailing address

850 E HARVARD AVE SUITE 255
DENVER CO
80210
US

V. Phone/Fax

Practice location:
  • Phone: 303-781-7140
  • Fax: 303-761-2536
Mailing address:
  • Phone: 303-781-7140
  • Fax: 303-761-2536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number15974
License Number StateCO

VIII. Authorized Official

Name: ROY R WRIGHT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 303-781-7140