MEDICARE: R J WRIGHT D O P 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	207Q00000X	Family Medicine Physician	1989	OK
2	207Q00000X	Family Medicine Physician	OK1989	OK

General Provider Information

NPI Number	:	1881629020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R J WRIGHT D O P C

Provider Business Mailing Address
First Line	:	5050 E KENOSHA
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74014
Country	:	US
Telephone Number	:	918-355-9492
Fax Number	:	918-355-9250

Provider Business Practice Location Address
First Line	:	5050 E KENOSHA
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74014
Country	:	US
Telephone Number	:	918-355-9492
Fax Number	:	918-355-9250

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT JEFFREY WRIGHT
Credential	:	DO
Telephone Number	:	918-355-9492

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	01/11/2011

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Directions to “R J WRIGHT D O P C ” Practice Location

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