Provider Demographics
NPI:1023310158
Name:WRIGHT, CARSON (PHYSCIAN)
Entity type:Individual
Prefix:
First Name:CARSON
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHYSCIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GILLETT ST
Mailing Address - Street 2:APT A4
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 MUNSON RD UNIVERSITY OF CONNECTICUT
Practice Address - Street 2:CORRECTIONAL MANAGED HEALTH CARE
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-5386
Practice Address - Country:US
Practice Address - Phone:860-763-6588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000543207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine