Healthcare Provider Details

I. General information

NPI: 1306087515
Provider Name (Legal Business Name): WRIGHT STATE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST SUITE 6257
DAYTON OH
45409-2939
US

IV. Provider business mailing address

5100 SPRINGFIELD ST SUITE 400
DAYTON OH
45431-1261
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-3999
  • Fax: 937-208-3682
Mailing address:
  • Phone: 937-259-9900
  • Fax: 937-259-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARET DUNN
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 937-259-9900