Healthcare Provider Details

I. General information

NPI: 1982903183
Provider Name (Legal Business Name): MICHAEL PATRICK WRIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 13TH AVE E
POLSON MT
59860-5315
US

IV. Provider business mailing address

2360 MULLAN RD STE C
MISSOULA MT
59808-1811
US

V. Phone/Fax

Practice location:
  • Phone: 406-883-5680
  • Fax: 406-883-8910
Mailing address:
  • Phone: 406-721-4436
  • Fax: 406-721-6053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMED-PHYS-LIC-52442
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMED-PHYS-LIC-52442
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: