Individual
STEPHEN J WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
299 E PENDLETON AVE, # 547, LAPEL, IN 46051-5546
(765) 534-3636
(765) 534-3638
Mailing address
299 E PENDLETON AVE, P.O. BOX 547, LAPEL, IN 46051-5546
(765) 534-3636
(765) 534-3638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028188A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000312904
ANTHEM
IN
05
—
100171430
—
IN
01
—
15D2075563
CLIA
IN
01
—
46-4572927
TAX ID WFP
IN
01
—
P01309423
PALMETO RAILROAD MEDICARE
IN
Enumeration date
07/27/2006
Last updated
03/07/2024
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