MEDICARE: CARL D WRIGHT PA

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
1	363A00000X	Physician Assistant	0110001332	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1114934072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL D WRIGHT PA

Provider Business Mailing Address
First Line	:	131 JENNICK DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-4905
Country	:	US
Telephone Number	:	804-526-5888
Fax Number	:	804-526-5401

Provider Business Practice Location Address
First Line	:	13038 RIVERS BEND RD
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23836-2564
Country	:	US
Telephone Number	:	804-530-3330
Fax Number	:	804-530-9998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	03/07/2023

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Directions to “ CARL D WRIGHT PA” Practice Location

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