Provider Demographics
NPI:1811098411
Name:WRIGHT, GARY D (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 BROWNING WAY
Mailing Address - Street 2:104
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8335
Mailing Address - Country:US
Mailing Address - Phone:775-753-5337
Mailing Address - Fax:775-753-5339
Practice Address - Street 1:1775 BROWNING WAY
Practice Address - Street 2:104
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8335
Practice Address - Country:US
Practice Address - Phone:775-753-5337
Practice Address - Fax:775-753-5339
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11455207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507545Medicaid
NV100507545Medicaid
NVC23804Medicare UPIN