Provider Demographics
NPI:1063801363
Name:JAMES R WRIGHT PCS
Entity type:Organization
Organization Name:JAMES R WRIGHT PCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-384-1700
Mailing Address - Street 1:2004 CALLIE WAY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-7521
Mailing Address - Country:US
Mailing Address - Phone:859-384-1700
Mailing Address - Fax:
Practice Address - Street 1:2004 CALLIE WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7521
Practice Address - Country:US
Practice Address - Phone:859-384-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4771302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization