Provider Demographics
NPI:1053450510
Name:WRIGHT, CURTIS MCNEELY (PA-C)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:MCNEELY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 MILL BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8623
Mailing Address - Country:US
Mailing Address - Phone:803-279-9258
Mailing Address - Fax:
Practice Address - Street 1:616 EDGEFIELD RD STE 180
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-6407
Practice Address - Country:US
Practice Address - Phone:803-279-7666
Practice Address - Fax:803-279-0708
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1160FP363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ76830Medicare UPIN