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General NPI Number Information
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NPI Number | 1023317328
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Entity Type | Individual
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Provider Name | BRAD WRIGHT MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 3321 S 3010 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-3170
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Country | US
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Telephone | 802-310-2843
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Fax |
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Provider Business Mailing Address
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Address Line | 3321 S 3010 E
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-3170
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Country | US
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Telephone | 802-310-2843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 8172696-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 8172696-1205
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License Number State | UT
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