Provider Demographics
NPI:1720467871
Name:WRIGHT, MICHAEL DOUGLASS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DOUGLASS
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 E REDONDO AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3826
Mailing Address - Country:US
Mailing Address - Phone:801-558-1968
Mailing Address - Fax:801-935-4000
Practice Address - Street 1:1671 E REDONDO AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3826
Practice Address - Country:US
Practice Address - Phone:801-558-1968
Practice Address - Fax:801-935-4000
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6277546-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist