Provider Demographics
NPI:1003920042
Name:WRIGHT, MANFORD ALEXANDER JR (MD)
Entity Type:Individual
Prefix:
First Name:MANFORD
Middle Name:ALEXANDER
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M.
Other - Middle Name:ALEXANDER
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:600 WILSON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-2751
Mailing Address - Country:US
Mailing Address - Phone:859-301-8074
Mailing Address - Fax:859-301-4945
Practice Address - Street 1:600 WILSON CREEK RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2751
Practice Address - Country:US
Practice Address - Phone:859-301-8074
Practice Address - Fax:859-301-4945
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235176207R00000X
KY42682208M00000X, 207R00000X
IN01087247A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50028788OtherPASSPORT- NORTON INPATIENT SPECIALISTS
KY7100073150OtherHUMANA- NORTON INPATIENT SPECIALISTS
IN200984610Medicaid
KY000000665061OtherANTHEM- NORTON INPATIENT SPECIALISTS
KY114852OtherSIHO- NORTON INPATIENT SPECIALISTS
KY7100073150Medicaid
KY50028788OtherPASSPORT- NORTON INPATIENT SPECIALISTS
NYI36656Medicare UPIN