Provider Demographics
NPI:1275525560
Name:WRIGHT, CREIGHTON B SR (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:CREIGHTON
Middle Name:B
Last Name:WRIGHT
Suffix:SR
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 MERCY HEALTH BLVD
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-1103
Mailing Address - Country:US
Mailing Address - Phone:513-215-5030
Mailing Address - Fax:513-215-5954
Practice Address - Street 1:3300 MERCY HEALTH BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1103
Practice Address - Country:US
Practice Address - Phone:513-215-5030
Practice Address - Fax:513-215-5954
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21791208G00000X, 208600000X, 2086S0129X, 174400000X
OH35046888W208600000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000005036OtherANTHEM
1820074OtherUNITEDHEALTHCARE
OH0473947Medicaid
46888OtherCHOICE CARE/HUMANA
KY64217912Medicaid
8330OtherKY BCBS
IN200058090BMedicaid
C02203Medicare UPIN
KY64217912Medicaid
330004277Medicare PIN
KY3400133Medicare PIN
KY0655051Medicare PIN
KYP00624831Medicare PIN
1820074OtherUNITEDHEALTHCARE
OH0473947Medicaid
KY0677807Medicare PIN
46888OtherCHOICE CARE/HUMANA
KY64217912Medicaid
KY3400133Medicare PIN
KY0677807Medicare PIN
OH0473947Medicaid