Provider Demographics
NPI:1073610945
Name:WRIGHT, LORAH L (DO)
Entity Type:Individual
Prefix:
First Name:LORAH
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:LORAH
Other - Middle Name:
Other - Last Name:MACINTOSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:945 E 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686
Mailing Address - Country:US
Mailing Address - Phone:231-935-0695
Mailing Address - Fax:231-935-0698
Practice Address - Street 1:945 E 8TH STREET
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686
Practice Address - Country:US
Practice Address - Phone:231-935-0695
Practice Address - Fax:231-935-0698
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILW011162207Q00000X
MI5101011162207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1366626889OtherLORAH L WRIGHT DO PLLC
MI1073610945OtherLORAH L WRIGHT DO
MI0852801684OtherBLUE CROSS BLUE SHIELD
MI0852801684OtherBLUE CROSS BLUE SHIELD
MI1366626889OtherLORAH L WRIGHT DO PLLC