Individual
DR. CHARLES JOHN WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3501 S SONCY RD STE 104, AMARILLO, TX 79119-6405
(806) 398-3627
(806) 351-7801
Mailing address
367 S GULPH RD, ATTN :IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(484) 913-7467
(610) 878-3965
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036-082040
IL
207T00000X
Neurological Surgery Physician
G059721
CA
207T00000X
Neurological Surgery Physician
Primary
N7599
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1H4413
PTAN
TX
05
—
2012577-07
—
TX
Enumeration date
04/13/2006
Last updated
05/07/2021
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