Healthcare Provider Details

I. General information

NPI: 1053450510
Provider Name (Legal Business Name): CURTIS MCNEELY WRIGHT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 EDGEFIELD RD STE 180
NORTH AUGUSTA SC
29841-6407
US

IV. Provider business mailing address

334 MILL BRANCH WAY
NORTH AUGUSTA SC
29860-8623
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-7666
  • Fax: 803-279-0708
Mailing address:
  • Phone: 803-279-9258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1160FP
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: