Provider Demographics
NPI:1205840725
Name:WRIGHT, DAVID G (OD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:G
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 POST RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1840
Mailing Address - Country:US
Mailing Address - Phone:401-884-5319
Mailing Address - Fax:401-884-5319
Practice Address - Street 1:6500 POST ROAD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-1840
Practice Address - Country:US
Practice Address - Phone:401-884-5319
Practice Address - Fax:401-884-5319
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTA00350152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI549600OtherAETNA
RI97448OtherBLUE CROSS BLUE SHIELD
RI0415581OtherCIGNA HEALTHCARE
RI003165OtherBLUE CHIP
RI2202743OtherUNITED HEALTHCARE
RI9009744Medicaid
RI549600OtherAETNA
RI0518510001Medicare NSC
T53326Medicare UPIN