MEDICARE: DR. RICHARD L WRIGHT JR. M.D.

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	207Q00000X	Family Medicine Physician	ME 30926	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00343414	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ME30926	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1144284217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD L WRIGHT JR. M.D.

Provider Business Mailing Address
First Line	:	221 SW STONEGATE TER STE 101
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32024-3463
Country	:	US
Telephone Number	:	386-755-0421
Fax Number	:	386-487-1234

Provider Business Practice Location Address
First Line	:	221 SW STONEGATE TER STE 101
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32024-3463
Country	:	US
Telephone Number	:	386-755-0421
Fax Number	:	386-487-1234

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	05/01/2024

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