Provider Demographics
NPI:1679550503
Name:WRIGHT, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
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:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-358-0011
Mailing Address - Fax:515-358-0099
Practice Address - Street 1:1111 6TH AVE STE A100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2610
Practice Address - Country:US
Practice Address - Phone:515-358-0011
Practice Address - Fax:515-358-0099
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-295572084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0104224Medicaid
A96209OtherJOHN DEERE HEALTHCARE
58417OtherWELLMARK
1764410OtherUNITED HEALTHCARE
130016063OtherRAILROAD MEDICARE
1764410OtherUNITED HEALTHCARE
130016063OtherRAILROAD MEDICARE
IA58417Medicare ID - Type Unspecified