Individual
DR. RUSSELL W WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, C/O BOISE RADIOLOGY GROUP, BOISE, ID 83712-6241
(208) 381-2094
Mailing address
115 W MAIN ST STE 202, BOISE, ID 83702-7303
(208) 433-9466
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
250292
MA
2085R0202X
Diagnostic Radiology Physician
Primary
M-11892
ID
2085R0202X
Diagnostic Radiology Physician
N1961
TX
Other
Enumeration date
01/20/2009
Last updated
10/22/2019
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