Provider Demographics
NPI:1356560486
Name:WRIGHT STATE UNIVERSITY
Entity type:Organization
Organization Name:WRIGHT STATE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASST. VICE PRESIDENT, RSP
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:937-775-2425
Mailing Address - Street 1:3640 COLONEL GLENN HWY
Mailing Address - Street 2:201J UNIVERSITY HALL
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45435-0001
Mailing Address - Country:US
Mailing Address - Phone:937-775-2425
Mailing Address - Fax:937-775-3781
Practice Address - Street 1:9 N. EDWIN C. MOSES BLVD.
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-6837
Practice Address - Country:US
Practice Address - Phone:937-775-4300
Practice Address - Fax:937-775-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare