Individual
GARY A WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 VILLAGE DR, PENDLETON, IN 46064-8960
(765) 778-0913
Mailing address
75 VILLAGE DR, PENDLETON, IN 46064-8960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01054539A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10817494
CAQH
—
05
—
200335410
—
IN
05
—
200335410A
—
IN
01
—
CK6957
RAILROAD GROUP
IN
01
—
DC3600
RAILROAD GROUP
IN
01
—
P00724971
RAILROAD INDIVIDUAL
IN
01
—
P00728697
RAILROAD INDIVIDUAL
IN
Enumeration date
07/03/2006
Last updated
05/18/2022
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