Provider Demographics
NPI:1346334844
Name:G. WILLIAM COURTRIGHT, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:G. WILLIAM COURTRIGHT, M.D., A MEDICAL CORPORATION
Other - Org Name:WOUND TECHNOLOGY NETWORK - CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:G
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:COURTRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-344-8175
Mailing Address - Street 1:395 REDWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-1340
Mailing Address - Country:US
Mailing Address - Phone:323-344-8175
Mailing Address - Fax:425-799-9797
Practice Address - Street 1:395 REDWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1340
Practice Address - Country:US
Practice Address - Phone:323-344-8175
Practice Address - Fax:425-799-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty