Provider Demographics
NPI:1407839574
Name:WRIGHT, JAMES D (LP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7570 W 21ST ST N STE 1026D
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1764
Mailing Address - Country:US
Mailing Address - Phone:316-634-4700
Mailing Address - Fax:316-634-4770
Practice Address - Street 1:7570 W 21ST ST N STE 1026D
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1764
Practice Address - Country:US
Practice Address - Phone:316-634-4700
Practice Address - Fax:316-634-4770
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1147103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
P42191Medicare UPIN
119697Medicare ID - Type Unspecified