Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 022669 | GA |
NPI | 1245268176 |
---|---|
Provider Name | Jean A Wright |
First Address | Savannah, GA 31404-6220 |
Second Address | Savannah, GA 31404-6220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 25/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000266626H | (05) | GA |
10065828 | AMERIGROUP (01) | GA |
349842 | WELLCARE (01) | GA |
D42349 | (02) | |
Q22669 | (05) | SC |