Provider Demographics
NPI:1164884391
Name:WRIGHT, JOSEPHINE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPHINE BERNICE
Other - Middle Name:DY
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF UTAH 30 NORTH 1900 EAST 4C104
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:705 6TH AVE E
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5008
Practice Address - Country:US
Practice Address - Phone:406-755-7366
Practice Address - Fax:406-755-7277
Is Sole Proprietor?:No
Enumeration Date:2016-03-26
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PHYS-LIC-127425207R00000X
UT10516760-1205207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program