Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 25542 | NC |
NPI | 1003895855 |
---|---|
Provider Name | Dr. Walter L Wright |
First Address | La Grange, NC 28551-8702 |
Second Address | Kinston, NC 28501-1501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 18/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01153 | BCBS GROUP # (01) | NC |
1538151279 | NPI GROUP (01) | NC |
8901153 | (05) | NC |
89526 | BCBS PROV # (01) | NC |
8989526 | (05) | NC |
C87300 | (02) | NC |