Provider Demographics
NPI:1194728451
Name:WRIGHT, B CODY (MD)
Entity type:Individual
Prefix:DR
First Name:B
Middle Name:CODY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BENJAMIN
Other - Middle Name:CODY
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:177 SAWTOOTH OAK ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7160
Mailing Address - Country:US
Mailing Address - Phone:501-520-6353
Mailing Address - Fax:
Practice Address - Street 1:177 SAWTOOTH OAK ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7160
Practice Address - Country:US
Practice Address - Phone:501-520-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ339272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ33927OtherAZ LICENSE
AZAPPLIED FORMedicaid
AZCAQHOther11460996
AZ202744723OtherTAX ID
AZ202744723OtherTAX ID
AZAPPLIED FORMedicare ID - Type Unspecified