Healthcare Provider Details

I. General information

NPI: 1699710640
Provider Name (Legal Business Name): TENIESHA NICOLE WRIGHT-JONES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TENIESHA NICHOLE WRIGHT DO

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22250 PROVIDENCE DR STE 500 DEIGHTON FAMILY PRACTICE
SOUTHFIELD MI
48075-6213
US

IV. Provider business mailing address

43750 GARFIELD RD SUITE 211
CLINTON TOWNSHIP MI
48038-1135
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3441
  • Fax: 248-849-5389
Mailing address:
  • Phone: 877-996-9975
  • Fax: 586-228-4533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101015647
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: