Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 5042 | NV |
NPI | 1356300743 |
---|---|
Provider Name | Dr. Jeffrey Allen Wrightson |
First Address | Las Vegas, NV 89148-4858 |
Second Address | Las Vegas, NV 89144-6646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 01/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002002914 | (05) | NV |
C96718 | (02) | NV |