Healthcare Provider Details

I. General information

NPI: 1437573664
Provider Name (Legal Business Name): WRIGHT FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2014
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 E PENDLETON AVE
LAPEL IN
46051-5546
US

IV. Provider business mailing address

299 E PENDLETON AVE BX 547
LAPEL IN
46051-5546
US

V. Phone/Fax

Practice location:
  • Phone: 765-534-3636
  • Fax: 765-534-3638
Mailing address:
  • Phone: 765-534-3636
  • Fax: 765-534-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number71002634A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01028188B
License Number StateIN

VIII. Authorized Official

Name: DR. STEPHEN J WRIGHT
Title or Position: M.D.
Credential: MD
Phone: 765-534-3636