Provider Demographics
NPI:1013912401
Name:WRIGHT, DEBORA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9811 HUMPHREY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5429
Mailing Address - Country:US
Mailing Address - Phone:513-791-4657
Mailing Address - Fax:
Practice Address - Street 1:6930 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3821
Practice Address - Country:US
Practice Address - Phone:513-891-6800
Practice Address - Fax:513-891-6803
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2008-07-02
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
OH4394152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH004154OtherVISION SERVICE PLAN
OH004154OtherVISION SERVICE PLAN
OHDE4019221Medicare ID - Type Unspecified