Provider Demographics
NPI:1770573552
Name:WRIGHT, RICHARD I (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:I
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:483 UPPER RIVERDALE RD SW STE 102
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2584
Mailing Address - Country:US
Mailing Address - Phone:770-996-9400
Mailing Address - Fax:770-991-2918
Practice Address - Street 1:483 UPPER RIVERDALE RD SW STE G
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2584
Practice Address - Country:US
Practice Address - Phone:770-996-9400
Practice Address - Fax:770-991-2918
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA046927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine