Provider Demographics
NPI:1184646580
Name:WRIGHT, JOHN HERMAN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HERMAN
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:145 KIMEL PARK DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6984
Mailing Address - Country:US
Mailing Address - Phone:336-768-1986
Mailing Address - Fax:336-768-3083
Practice Address - Street 1:145 KIMEL PARK DR
Practice Address - Street 2:SUITE 280
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6972
Practice Address - Country:US
Practice Address - Phone:336-768-1986
Practice Address - Fax:336-768-3083
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2013-02-13
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Provider Licenses
StateLicense IDTaxonomies
NC1147322086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89449OtherNC BLUE CROSS BLUE SHIELD