Provider Demographics
NPI:1134121890
Name:WRIGHT, DAVID J (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:100 MEDICAL PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-2607
Mailing Address - Country:US
Mailing Address - Phone:712-265-2700
Mailing Address - Fax:712-265-2745
Practice Address - Street 1:100 MEDICAL PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-2607
Practice Address - Country:US
Practice Address - Phone:712-265-2700
Practice Address - Fax:712-265-2745
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2016-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IADO-03226208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAFW8892OtherMEDICARE PTAN
H05913Medicare UPIN