Provider Demographics
NPI:1962475848
Name:WRIGHT, WILLIAM P JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:13303 TESSON FERRY RD
Mailing Address - Street 2:SUITE 55
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-4062
Mailing Address - Country:US
Mailing Address - Phone:314-270-3260
Mailing Address - Fax:314-270-3259
Practice Address - Street 1:13303 TESSON FERRY RD
Practice Address - Street 2:SUITE 55
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-4062
Practice Address - Country:US
Practice Address - Phone:314-270-3260
Practice Address - Fax:314-270-3259
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2020-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR3G97174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E24144Medicare UPIN
4011397Medicare ID - Type Unspecified