Provider Demographics
NPI:1245740547
Name:WRIGHT DERMATOLOGY, PLLC
Entity Type:Organization
Organization Name:WRIGHT DERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-228-7262
Mailing Address - Street 1:2046 PLEASANT PLAINS EXT RD STE F
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-6007
Mailing Address - Country:US
Mailing Address - Phone:731-783-3696
Mailing Address - Fax:731-215-0972
Practice Address - Street 1:2046 PLEASANT PLAINS EXT RD STE F
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-6006
Practice Address - Country:US
Practice Address - Phone:731-783-3696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty