Healthcare Provider Details

I. General information

NPI: 1245238427
Provider Name (Legal Business Name): TRENTON MCNEIL WRIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 N 1075 W STE 104
FARMINGTON UT
84025-2746
US

IV. Provider business mailing address

PO BOX 25488
SALT LAKE CITY UT
84125-0488
US

V. Phone/Fax

Practice location:
  • Phone: 801-298-1300
  • Fax: 801-296-6199
Mailing address:
  • Phone: 800-475-3698
  • Fax: 801-296-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number363215-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: