Provider Demographics
NPI:1861506768
Name:WRIGHT, BRIDGET M (MD)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1508 HARDEMAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1470
Mailing Address - Country:US
Mailing Address - Phone:478-742-3704
Mailing Address - Fax:478-741-7251
Practice Address - Street 1:1508 HARDEMAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1470
Practice Address - Country:US
Practice Address - Phone:478-742-3704
Practice Address - Fax:478-741-7251
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA057520207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA911689543AMedicaid
I51651Medicare UPIN
66BBBHWMedicare ID - Type Unspecified