Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0168R | OK |
NPI | 1003369133 |
---|---|
Provider Name | Jonathan Wright I |
First Address | Norman, OK 73069-7446 |
Second Address | Norman, OK 73071-6404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2016 |
Last Update Date | 25/07/2016 |