=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477536829
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LORI ANN ENGLAND-WRIGHT M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2005
-----------------------------------------------------
Last Update Date | 04/26/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 811 FAIRVIEW AVE
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42101-4969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-783-3573
-----------------------------------------------------
Fax | 270-783-4081
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1177
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42102-1177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-783-3573
-----------------------------------------------------
Fax | 270-467-0225
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 35483
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------