Healthcare Provider Details

I. General information

NPI: 1326332073
Provider Name (Legal Business Name): AMBER LADAWN WRIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2011
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CHANNING WAY
IDAHO FALLS ID
83404-7533
US

IV. Provider business mailing address

3780 HAMPSHIRE CT
IDAHO FALLS ID
83404-7973
US

V. Phone/Fax

Practice location:
  • Phone: 208-529-6111
  • Fax:
Mailing address:
  • Phone: 806-544-1839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5851591
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: