Individual
KENNETH DEAN WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2828 1ST AVE, SUITE 200, HUNTINGTON, WV 25702-1236
(304) 399-7530
(304) 399-7532
Mailing address
PO BOX 88, 5 E ALVON ROAD SUITE 7, WHITE SULPHUR SPRINGS, WV 24986-2373
(304) 536-5030
(304) 536-5051
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
157
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721578
BCBS MOUNTAIN STATE
WV
01
—
030028200
BLACK LUNG
WV
01
—
550357050
UNITED MINE WORKERS
WV
05
—
95690020
—
KY
Enumeration date
03/24/2006
Last updated
07/17/2013
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