Provider Demographics
NPI:1942200779
Name:WRIGHT, DAVID BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-0670
Mailing Address - Country:US
Mailing Address - Phone:901-751-9794
Mailing Address - Fax:901-756-7010
Practice Address - Street 1:8066 WALNUT RUN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8841
Practice Address - Country:US
Practice Address - Phone:901-751-9794
Practice Address - Fax:901-756-7010
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD013359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD013359OtherMEDICAL LICENSE
TN4177764OtherBLUE CROSS
TNAW3210250OtherDEA LICENSE
TNMD013359OtherMEDICAL LICENSE
TNA97888Medicare UPIN