Healthcare Provider Details

I. General information

NPI: 1831174663
Provider Name (Legal Business Name): DANIEL WRIGHT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 SAINT FRANCIS DR STE 510
WATERLOO IA
50702-5620
US

IV. Provider business mailing address

400 DERBYSHIRE RD
WATERLOO IA
50701-4257
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number03161
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: