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General NPI Number Information
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NPI Number | 1114920329
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Entity Type | Organization
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Legal Business Name | WRIGHT STATE PHYSICIANS INC
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 725 UNIVERSITY BLVD
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City | DAYTON
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State | OH
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Zip | 45435-0001
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Country | US
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Telephone | 937-245-7100
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Fax | 937-245-7999
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Provider Business Mailing Address
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Address Line | 725 UNIVERSITY BLVD
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City | FAIRBORN
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State | OH
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Zip | 45324-0000
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Country | US
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Telephone | 937-245-7100
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Fax | 937-245-7999
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KIMBERLY PAUL
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Credential |
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Telephone | 937-245-7125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 821388
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License Number State | OH
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Taxonomy #14
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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