Organization
WRIGHT DERMATOLOGY AND DIAGNOSTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA VIGIL (BILLING & RECEPTION)
(505) 988-5120
Entity
Organization
Contact information
Practice address
1850 OLD PECOS TRL, STE J, SANTA FE, NM 87505-4760
(505) 988-5120
(505) 982-1812
Mailing address
1850 OLD PECOS TRL, STE J, SANTA FE, NM 87505-4760
(505) 988-5120
(505) 982-1812
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2000-129
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11157598
CAQH
NM
01
—
2000-129
MEDICAL LICENSE
NM
Enumeration date
02/22/2011
Last updated
06/18/2012
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