# KENNETH DEAN WRIGHT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790745818
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 157 | WV | Yes |

## Other

- **Enumeration date:** 03/24/2006
- **Last updated:** 07/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001721578 | BCBS MOUNTAIN STATE | WV |
| 01 | — | 030028200 | BLACK LUNG | WV |
| 01 | — | 550357050 | UNITED MINE WORKERS | WV |
| 05 | — | 95690020 | — | KY |