Healthcare Provider Details

I. General information

NPI: 1053831990
Provider Name (Legal Business Name): MATTHEW THOMAS WRIGHT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

983075 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3075
US

IV. Provider business mailing address

2355 FACULTY DR
USAF ACADEMY CO
80840-1805
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number1970
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: