Provider Demographics
NPI:1619161403
Name:WRIGHT STATE PHYSICIANS
Entity Type:Organization
Organization Name:WRIGHT STATE PHYSICIANS
Other - Org Name:WOMENS HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-259-9900
Mailing Address - Street 1:5100 SPRINGFIELD ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1261
Mailing Address - Country:US
Mailing Address - Phone:937-259-9900
Mailing Address - Fax:866-527-1320
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:SUITE 4130
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-6810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-069001207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000359538OtherANTHEM
UN9256604Medicare PIN