Provider Demographics
NPI:1376760140
Name:BRIGHT, RICHARD HOMER (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HOMER
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 LONGVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2004
Mailing Address - Country:US
Mailing Address - Phone:540-942-5430
Mailing Address - Fax:540-942-5430
Practice Address - Street 1:94 LONGVIEW CIR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2004
Practice Address - Country:US
Practice Address - Phone:540-942-5430
Practice Address - Fax:540-942-5430
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055598207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC97-01261OtherSTATE LICENSE
VA0101055598OtherSTATE LICENSE
SC8320OtherSTATE LICENSE (INACTIVE)
GA044887OtherSTATE LICENSE (INACTIVE)
SC0832AMedicaid
OH21385OtherSTATE LICENSE (INACTIVE)
AB1406594OtherDEA
GA044887OtherSTATE LICENSE (INACTIVE)
AB1406594OtherDEA