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Individual

STEPHEN A WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 484-9603

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01046850A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01046850A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
058940Z
MEDICARE PTAN
IN
01
200026087
RAIL ROAD MEDICARE
IN
05
200142130
IN
05
2030457
OH
Enumeration date
08/09/2005
Last updated
10/22/2018
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