Healthcare Provider Details

I. General information

NPI: 1194852913
Provider Name (Legal Business Name): TODD B. WRIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NO. 16TH ST.
NEW CASTLE IN
47362-4319
US

IV. Provider business mailing address

PO BOX 445
NEW CASTLE IN
47362-0445
US

V. Phone/Fax

Practice location:
  • Phone: 765-521-1135
  • Fax: 765-521-1331
Mailing address:
  • Phone: 765-521-1135
  • Fax: 765-521-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01041625A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01041625
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: