Organization
WRIGHT STATE PHYSICIANS INC
Active
Parent organization
WRIGHT STATE PHYSICIANS
Organization subpart
Yes
Provider details
NPI number
Legal business name
WRIGHT STATE PHYSICIANS
Authorized official
ALAN MARCO MD (PRESIDENT CEO)
(937) 245-7100
Entity
Organization
Contact information
Practice address
725 UNIVERSITY BLVD, DAYTON, OH 45435-0001
(937) 245-7100
(937) 245-7999
Mailing address
725 UNIVERSITY BLVD, FAIRBORN, OH 45324
(937) 245-7100
(937) 245-7999
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
821388
OH
207Q00000X
Family Medicine Physician
821388
OH
207V00000X
Obstetrics & Gynecology Physician
821388
OH
207X00000X
Orthopaedic Surgery Physician
Primary
821388
OH
207ZD0900X
Dermatopathology (Pathology) Physician
821388
OH
208200000X
Plastic Surgery Physician
821388
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0914443
—
OH
01
—
1114920329
PARENT GROUP NPI
OH
01
—
821388
BUSINESS LICENSURE
OH
Enumeration date
05/30/2012
Last updated
06/13/2014
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