Healthcare Provider Details

I. General information

NPI: 1619271814
Provider Name (Legal Business Name): JAMES C WRIGHT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 CURTIS ELLIS DR
ROCKY MOUNT NC
27804-2237
US

IV. Provider business mailing address

250 FORBES ROAD
WAKE FOREST NC
27587
US

V. Phone/Fax

Practice location:
  • Phone: 252-962-8020
  • Fax:
Mailing address:
  • Phone: 919-210-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-02685
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: