Provider Demographics
NPI:1124090139
Name:WRIGHT, JESSE H III (MD)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:H
Last Name:WRIGHT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:401 E CHESTNUT ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-5700
Mailing Address - Country:US
Mailing Address - Phone:502-588-4450
Mailing Address - Fax:502-588-4427
Practice Address - Street 1:401 E CHESTNUT ST
Practice Address - Street 2:SUITE 610
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5700
Practice Address - Country:US
Practice Address - Phone:502-588-4450
Practice Address - Fax:502-588-9539
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY181652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64181654Medicaid
IN200422510Medicaid
KY395621OtherTRICARE
KY260052137Medicare PIN
KY395621OtherTRICARE
KY0878405Medicare PIN