Provider Demographics
NPI:1154392736
Name:WRIGHT, MARTHA J (OD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:J
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7685 HIGHWAY 59
Mailing Address - Street 2:SUITE A
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535
Mailing Address - Country:US
Mailing Address - Phone:251-955-3939
Mailing Address - Fax:251-955-3940
Practice Address - Street 1:7685 STATE HIGHWAY 59
Practice Address - Street 2:SUITE A
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535
Practice Address - Country:US
Practice Address - Phone:251-955-3939
Practice Address - Fax:251-955-3940
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-648-TA-377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51540012OtherBLUE CROSS BLUE SHIELD
AL9978780Medicaid
ALT69111Medicare UPIN