Organization
RICKEY WRIGHT MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKEY WRIGHT M.D. (OWNER)
(419) 334-7737
Entity
Organization
Contact information
Practice address
1823 W STATE ST, FREMONT, OH 43420-1635
(419) 334-7737
(419) 334-2528
Mailing address
1907 W STATE ST, FREMONT, OH 43420-1637
(419) 334-7737
(419) 334-2528
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35058763
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000484130
ANTHEM BCBS
—
05
—
2051014
—
OH
01
—
420846233-00
WORKERS COMPENSATION
OH
01
—
420846233-007
MEDICAL MUTUAL OF OHIO
—
Enumeration date
07/24/2007
Last updated
07/24/2007
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