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General NPI Number Information
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NPI Number | 1083273924
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Entity Type | Individual
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Provider Name | ISAAC WRIGHT OD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 2020 E RIO SALADO PKWY # 101
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City | TEMPE
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State | AZ
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Zip | 85281-3042
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Country | US
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Telephone | 480-967-0563
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Fax |
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Provider Business Mailing Address
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Address Line | 931 N HERITAGE
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City | MESA
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State | AZ
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Zip | 85201-3931
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Country | US
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Telephone | 480-980-3486
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002349
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License Number State | AZ
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