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General NPI Number Information
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NPI Number | 1386825339
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Entity Type | Organization
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Legal Business Name | B. CODY WRIGHT MD PC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 121 E BIRCH AVE STE 503
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4621
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Country | US
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Telephone | 928-213-5600
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Fax | 928-213-5999
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Provider Business Mailing Address
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Address Line | 121 E BIRCH AVE STE 503
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4621
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Country | US
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Telephone | 928-213-5600
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Fax | 928-213-5999
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Authorized Official
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Title or Position | PRESIDENT
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Name | B. CODY WRIGHT
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Credential | MD
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Telephone | 928-213-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 33927
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License Number State | AZ
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