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NPI Code Detail

MEDICARE: RONNIE O'DELL WRIGHT

MEDICARE:   RONNIE O'DELL WRIGHT
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
11710I1003XIndependent Duty Medical Technicians

General Provider Information

NPI Number : 1093941403
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONNIE O'DELL WRIGHT
Provider Business Mailing Address
First Line : PSC 112 BOX 18
Second Line :
City : APO
State : AE
Zip : 09717-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : PSC 112 BOX 18
Second Line :
City : APO
State : AE
Zip : 09717-0001
Country : US
Telephone Number : 00316519353503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2009
Last Update Date : 06/01/2009

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Directions to “ RONNIE O'DELL WRIGHT ” Practice Location

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