Provider Demographics
NPI:1598771677
Name:WRIGHT, STEVEN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HOWARD
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 1:1614 W 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7006
Mailing Address - Country:US
Mailing Address - Phone:870-534-6800
Mailing Address - Fax:870-534-6846
Practice Address - Street 1:1614 W 42ND AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7006
Practice Address - Country:US
Practice Address - Phone:870-534-6800
Practice Address - Fax:870-534-6846
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR621705355174400000X
ARE-1343207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131590001Medicaid
ARG48063Medicare UPIN
AR5K462Medicare ID - Type Unspecified