Healthcare Provider Details

I. General information

NPI: 1508995390
Provider Name (Legal Business Name): TERESA SUE WRIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 N DUNLAP ST RM 102
MEMPHIS TN
38103-2802
US

IV. Provider business mailing address

49 N DUNLAP ST RM 102
MEMPHIS TN
38103-2802
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-7496
  • Fax: 901-266-6620
Mailing address:
  • Phone: 901-287-7496
  • Fax: 901-266-6620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberN1229
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN1229
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number52576
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: