Provider Demographics
NPI:1669968467
Name:WRIGHT, EMMA LEE (DO)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:LEE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:LEE
Other - Last Name:HAYDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-629-3341
Mailing Address - Fax:573-629-3416
Practice Address - Street 1:6500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6890
Practice Address - Country:US
Practice Address - Phone:573-629-3441
Practice Address - Fax:573-629-3416
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018020626208000000X
MO2021021952208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics