Individual
LISA M WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
276 N RON MCNAIR BLVD, LAKE CITY, SC 29560-2462
(843) 394-5471
(433) 945-4598
Mailing address
276 N RON MCNAIR BLVD, LAKE CITY, SC 29560-2462
(843) 394-5471
(433) 945-4598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25363
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253638
—
SC
01
—
576007863002
BLUE CHOICE OF SC
SC
01
—
P00352728
RR MEDICARE
SC
Enumeration date
06/05/2006
Last updated
10/10/2023
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