Individual
DR. DAVID ALLEN WIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7019 ROTE RD STE 105, ROCKFORD, IL 61107-2611
(815) 381-0900
Mailing address
7019 ROTE RD STE 105, ROCKFORD, IL 61107-2611
(815) 381-0900
(815) 395-1775
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-100362
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G41805
UPIN
IL
Enumeration date
08/07/2007
Last updated
07/17/2019
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