Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | IL |
NPI | 1902857717 |
---|---|
Provider Name | Dr. David N Wright |
First Address | Springfield, IL 62702-4978 |
Second Address | Springfield, IL 62702-4978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0360955601 | (05) | IL |
D61511 | (02) | IL |