Provider Demographics
NPI:1154704377
Name:WRIGHT, THOMAS (DPM)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 W KAGY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-5879
Mailing Address - Country:US
Mailing Address - Phone:406-586-5318
Mailing Address - Fax:406-586-1635
Practice Address - Street 1:1125 W KAGY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-5879
Practice Address - Country:US
Practice Address - Phone:406-586-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT76502213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty