Healthcare Provider Details

I. General information

NPI: 1013390756
Provider Name (Legal Business Name): GREGORY WRIGHT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 GREENWOOD DR STE C
HILTON HEAD ISLAND SC
29928-4539
US

IV. Provider business mailing address

2 GREENWOOD DR STE C
HILTON HEAD SC
29928-4539
US

V. Phone/Fax

Practice location:
  • Phone: 843-341-2700
  • Fax: 843-341-2702
Mailing address:
  • Phone: 843-341-2700
  • Fax: 843-341-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA057616
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: