Provider Demographics
NPI:1205137585
Name:WRIGHT, ATO O (MD/PHD)
Entity type:Individual
Prefix:DR
First Name:ATO
Middle Name:O
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SPRINT DR
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-7696
Mailing Address - Country:US
Mailing Address - Phone:717-960-3750
Mailing Address - Fax:
Practice Address - Street 1:2035 TECHNOLOGY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9422
Practice Address - Country:US
Practice Address - Phone:717-724-6740
Practice Address - Fax:717-724-6741
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT196821207R00000X
PAMD4626952085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103391124Medicaid