MEDICARE: MR. NATHAN BARRETT WRIGHT PA-C

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	363AM0700X	Medical Physician Assistant	132131	NC
2	363A00000X	Physician Assistant	0010-00382	NC

General Provider Information

NPI Number	:	1275573537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NATHAN BARRETT WRIGHT PA-C

Provider Business Mailing Address
First Line	:	2874 WARD BLVD
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893
Country	:	US
Telephone Number	:	252-291-5600
Fax Number	:	252-291-6935

Provider Business Practice Location Address
First Line	:	2874 WARD BLVD
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-1761
Country	:	US
Telephone Number	:	252-291-5600
Fax Number	:	252-291-6935

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	09/08/2017

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