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General NPI Number Information
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NPI Number | 1669650644
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Entity Type | Organization
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Legal Business Name | PHILLIP G. WRIGHT, OPTOMETRIST, LTD
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 740 N MAIN ST
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City | PROVIDENCE
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State | RI
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Zip | 02904-5702
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Country | US
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Telephone | 401-521-5500
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Fax | 401-272-8284
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Provider Business Mailing Address
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Address Line | 740 N MAIN ST
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City | PROVIDENCE
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State | RI
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Zip | 02904-5702
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Country | US
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Telephone | 401-521-5500
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Fax | 401-272-8284
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILLIP GEORGE WRIGHT
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Credential | O.D.
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Telephone | 401-521-5500
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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 | ODTA00349
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License Number State | RI
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