Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | K1730 | TX |
N | 208600000X | Surgeon | K1730 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 126936 | AK |
N | 2086S0122X | Plastic and Reconstructive Surgery | K1730 | TX |
NPI | 1134291503 |
---|---|
Provider Name | Dr. Mary J Wright |
First Address | Anchorage, AK 99503-3984 |
Second Address | Anchorage, AK 99503-3984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 14/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
310028103 | (05) | TX |
475411YWWW | (02) | TX |