Provider Demographics
NPI:1245039734
Name:BRIGHT, SAMUEL WESLEY
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:WESLEY
Last Name:BRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9261 HEDGE ROW CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9674
Mailing Address - Country:US
Mailing Address - Phone:937-350-7125
Mailing Address - Fax:
Practice Address - Street 1:498 OLDE MILL DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-1028
Practice Address - Country:US
Practice Address - Phone:614-607-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker