Provider Demographics
NPI:1255370805
Name:WRIGHT, HARRY GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:GEORGE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9075
Mailing Address - Country:US
Mailing Address - Phone:989-723-4732
Mailing Address - Fax:
Practice Address - Street 1:259 N STATE RD
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9075
Practice Address - Country:US
Practice Address - Phone:989-723-4732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHW040772207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIHW040772OtherSTATE LICENCE
MI540G802560OtherBLUECROSS BLUE SHIELD
MIMI4992001Medicare PIN