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Individual

DR. BRENT DOUGLAS WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
A67482
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EH816A
PTAN
CA
05
FHC03967F
CA
Enumeration date
03/16/2007
Last updated
08/29/2012
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