Provider Demographics
NPI:1750477576
Name:WRIGHT, ERIC A (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 BREWSTER STREET
Mailing Address - Street 2:MEMORIAL HOSPITAL OF RHODE ISLAND
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-729-3481
Mailing Address - Fax:401-729-3866
Practice Address - Street 1:310 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-3430
Practice Address - Country:US
Practice Address - Phone:401-729-3481
Practice Address - Fax:401-729-3866
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00612207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007058917Medicare ID - Type UnspecifiedBUC PROVIDER #
RI007058936Medicare UPIN
RII65602Medicare UPIN