Provider Demographics
NPI:1750378287
Name:WRIGHT, JEFFREY STEVEN (PA-C)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:STEVEN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 PARK ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-5205
Mailing Address - Country:US
Mailing Address - Phone:704-829-0025
Mailing Address - Fax:704-829-0031
Practice Address - Street 1:209 PARK ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-5205
Practice Address - Country:US
Practice Address - Phone:704-829-0025
Practice Address - Fax:704-829-0031
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC102379363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant