Provider Demographics
NPI:1366626889
Name:LORAH L WRIGHT DO PLLC
Entity Type:Organization
Organization Name:LORAH L WRIGHT DO PLLC
Other - Org Name:LORAH L WRIGHT DO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-935-0695
Mailing Address - Street 1:945 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2786
Mailing Address - Country:US
Mailing Address - Phone:231-935-0695
Mailing Address - Fax:231-935-0698
Practice Address - Street 1:945 E 8TH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2786
Practice Address - Country:US
Practice Address - Phone:231-935-0695
Practice Address - Fax:231-935-0698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51101011162207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF00562OtherPRIORITY
MI1073610945Medicaid
MI080B812250OtherBCBS
MI1366626889OtherLORAH L WRIGHT DO PLLC
MI0B812250OtherBCBS OF MICHIGAN
MIF00562OtherPRIORITY
MIF00562Medicare UPIN