Provider Demographics
NPI:1538290317
Name:WRIGHT, FRANKLIN RAY JR (O D)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:RAY
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 COVEY RUN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-4723
Mailing Address - Country:US
Mailing Address - Phone:601-260-6877
Mailing Address - Fax:
Practice Address - Street 1:15672 STATE HIGHWAY 180
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-8258
Practice Address - Country:US
Practice Address - Phone:601-260-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS493152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00087912Medicaid
MST21194Medicare UPIN
302I414972Medicare PIN