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General NPI Number Information
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NPI Number | 1104446103
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Entity Type | Individual
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Provider Name | TRACEY ALBERTHA LOCKHART WRIGHT MD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 33333 W 12 MILE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3312
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Country | US
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Telephone | 248-536-2127
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Fax | 248-893-6952
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Provider Business Mailing Address
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Address Line | 33333 W 12 MILE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3312
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Country | US
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Telephone | 248-536-2127
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Fax | 248-893-6852
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301509873
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-15558
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License Number State | AR
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