Provider Demographics
NPI:1407944887
Name:WRIGHT, GILL C (MD)
Entity Type:Individual
Prefix:DR
First Name:GILL
Middle Name:C
Last Name:WRIGHT
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 1:9040 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3902
Mailing Address - Country:US
Mailing Address - Phone:913-888-1151
Mailing Address - Fax:
Practice Address - Street 1:9040 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3902
Practice Address - Country:US
Practice Address - Phone:913-888-1151
Practice Address - Fax:913-888-1822
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-22544207Q00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSK21C641Medicare ID - Type Unspecified
E48225Medicare UPIN