Provider Demographics
NPI:1821261108
Name:WRIGHT PAIN MANAGEMENT INC
Entity Type:Organization
Organization Name:WRIGHT PAIN MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF COMPANY
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:623-433-0199
Mailing Address - Street 1:PO BOX 94568
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85070-4568
Mailing Address - Country:US
Mailing Address - Phone:480-361-7680
Mailing Address - Fax:480-361-7683
Practice Address - Street 1:13065 W MCDOWELL RAOD
Practice Address - Street 2:SUITE C-101
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4568
Practice Address - Country:US
Practice Address - Phone:623-535-5629
Practice Address - Fax:623-535-5639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34682207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ971475Medicaid
AZ2Z8001OtherHEALTHNET
AZ2Z8001OtherHEALTHNET