Healthcare Provider Details

I. General information

NPI: 1669399747
Provider Name (Legal Business Name): ALLISON WRIGHT MD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ALCORN DR
CORINTH MS
38834-9368
US

IV. Provider business mailing address

1030 E 6TH ST
CORINTH MS
38834-3601
US

V. Phone/Fax

Practice location:
  • Phone: 270-314-6561
  • Fax:
Mailing address:
  • Phone: 270-314-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberWRIG-5OQSOP
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: