Provider Demographics
NPI:1457309791
Name:WRIGHT, JAMES LEE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-8244
Mailing Address - Country:US
Mailing Address - Phone:804-379-3835
Mailing Address - Fax:804-379-3835
Practice Address - Street 1:4403 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-3241
Practice Address - Country:US
Practice Address - Phone:804-379-3835
Practice Address - Fax:804-379-3835
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G74008Medicare UPIN