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General NPI Number Information
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NPI Number | 1457498388
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Entity Type | Organization
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Legal Business Name | DRS. PHILLIP R. & DAWN E. WRIGHT, OPTOMETRISTS INC PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 401 S INDIANA ST SUITE C
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City | MOORESVILLE
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State | IN
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Zip | 46158-2798
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Country | US
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Telephone | 317-831-4071
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Fax | 317-831-4489
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Provider Business Mailing Address
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Address Line | 401 S INDIANA ST SUITE C
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City | MOORESVILLE
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State | IN
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Zip | 46158-2798
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Country | US
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Telephone | 317-831-4071
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Fax | 317-831-4489
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILLIP R. WRIGHT
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Credential | OD
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Telephone | 317-831-4071
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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 | 56000095A
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License Number State | IN
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