Provider Demographics
NPI:1831240860
Name:WRIGHT, MICHAEL A (DPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5897 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-4137
Mailing Address - Country:US
Mailing Address - Phone:931-289-5995
Mailing Address - Fax:931-289-5997
Practice Address - Street 1:5897 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061-4137
Practice Address - Country:US
Practice Address - Phone:931-289-5995
Practice Address - Fax:931-289-5997
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist