Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1013044437 |
---|---|
Provider Name | William Brent Wright |
First Address | Kinston, NC 28503-1495 |
Second Address | Kinston, NC 28504-8859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0414L | BLUE CROSS BLUE SHIELD (01) | NC |
7795310 | (05) | NC |