Provider Demographics
NPI:1194852913
Name:WRIGHT, TODD B (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:B
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0445
Mailing Address - Country:US
Mailing Address - Phone:765-521-1135
Mailing Address - Fax:765-521-1331
Practice Address - Street 1:1000 NO. 16TH ST.
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-4319
Practice Address - Country:US
Practice Address - Phone:765-521-1135
Practice Address - Fax:765-521-1331
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041625A2085R0202X
IN010416252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000083924OtherANTHEM
300074064OtherRAILROAD MEDICARE
IN200103790Medicaid
IN352580KMedicare PIN
IN000000083924OtherANTHEM