Provider Demographics
NPI:1760465140
Name:WRIGHT, DONALD R (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
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 1:8240 NAAB RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5927
Mailing Address - Country:US
Mailing Address - Phone:317-415-1000
Mailing Address - Fax:317-415-1010
Practice Address - Street 1:8240 NAAB RD
Practice Address - Street 2:SUITE 400
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5927
Practice Address - Country:US
Practice Address - Phone:317-415-1000
Practice Address - Fax:317-415-1010
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2015-02-03
Deactivation Date:2014-10-16
Deactivation Code:
Reactivation Date:2015-02-03
Provider Licenses
StateLicense IDTaxonomies
IN01027588A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100382050Medicaid
IN677690ZMedicare PIN
IN160020848Medicare PIN
IN100382050Medicaid