Healthcare Provider Details

I. General information

NPI: 1902873524
Provider Name (Legal Business Name): STEPHANIE MARIE WRIGHT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10465 PARK MEADOWS DR STE 201
LONE TREE CO
80124-5321
US

IV. Provider business mailing address

10465 PARK MEADOWS DR STE 201
LONE TREE CO
80124-5321
US

V. Phone/Fax

Practice location:
  • Phone: 303-790-1515
  • Fax: 303-790-1989
Mailing address:
  • Phone: 303-790-1515
  • Fax: 303-790-1989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number20A9447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: