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Individual

DR. JOHNNY C WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., D.P.M.

Contact information

Practice address
340 BROAD ST, SUITE 100, WINDSOR, CT 06095-3030
(860) 580-7170
(860) 580-7177
Mailing address
340 BROAD ST, STE 100, WINDSOR, CT 06095-3030
(413) 505-4888

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049981
CT
213EP1101X
Primary Podiatric Medicine Podiatrist
80178
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008045010
CT
05
008056720
CT
01
1679974521
NPI
Enumeration date
01/23/2007
Last updated
03/02/2016
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