Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 3469 | IA |
NPI | 1053307314 |
---|---|
Provider Name | Dr. Daniel W Wright |
First Address | Newton, IA 50208-3135 |
Second Address | Newton, IA 50208-3135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 10/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0443143 | (05) | IA |
36556 | BCBS (01) | |
H80658 | (02) |