Healthcare Provider Details

I. General information

NPI: 1487278297
Provider Name (Legal Business Name): BREYDAN HAWKINS WRIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 COMPETITION DR STE 100
BETTENDORF IA
52722-8837
US

IV. Provider business mailing address

5250 COMPETITION DR
BETTENDORF IA
52722-8837
US

V. Phone/Fax

Practice location:
  • Phone: 563-322-0971
  • Fax:
Mailing address:
  • Phone: 563-322-0971
  • Fax: 309-736-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number30729
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number70230
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number104474
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number57036
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: