Provider Demographics
NPI:1497735807
Name:WRIGHT, BILLIE SUE (DO)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:SUE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SYCAMORE CREEK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-2300
Mailing Address - Country:US
Mailing Address - Phone:937-748-4211
Mailing Address - Fax:937-748-3566
Practice Address - Street 1:5 SYCAMORE CREEK DR
Practice Address - Street 2:SUITE C
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-2300
Practice Address - Country:US
Practice Address - Phone:937-748-4211
Practice Address - Fax:937-748-3566
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007337W207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2306712Medicaid
OHH42914Medicare UPIN
OH2306712Medicaid
OH4056333Medicare PIN