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NPI Code Detail

MEDICARE: ERIC R WRIGHT PAC

MEDICARE:   ERIC R WRIGHT  PAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA10004627WA
2363A00000XPhysician Assistant0010-02694NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2NC8641AOTHERNCMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023109147
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC R WRIGHT PAC
Provider Business Mailing Address
First Line : 444 SW CENTER ST
Second Line : P.O. BOX 187
City : FAISON
State : NC
Zip : 28341-8820
Country : US
Telephone Number : 910-267-0421
Fax Number : 910-267-0441
Provider Business Practice Location Address
First Line : 360 E CHARITY RD
Second Line :
City : ROSE HILL
State : NC
Zip : 28458-8303
Country : US
Telephone Number : 910-289-3086
Fax Number : 910-267-8992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/28/2017

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