Provider Demographics
NPI:1437582913
Name:WRIGHT, GAYLE ANNE HENDRICKS (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLE ANNE
Middle Name:HENDRICKS
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:GAYLE
Other - Middle Name:ANNE
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:BG-2101A
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-5563
Mailing Address - Country:US
Mailing Address - Phone:706-721-9442
Mailing Address - Fax:706-721-9463
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-1500
Practice Address - Country:US
Practice Address - Phone:706-721-9442
Practice Address - Fax:706-721-9463
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009081207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine