Provider Demographics
NPI:1306330261
Name:WRIGHT, JASON CLARK (DPM)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:CLARK
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 1:9226 APPLEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-6257
Mailing Address - Country:US
Mailing Address - Phone:810-599-9318
Mailing Address - Fax:
Practice Address - Street 1:350 N MAIN ST STE 240
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1635
Practice Address - Country:US
Practice Address - Phone:734-433-5800
Practice Address - Fax:734-433-5801
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5951000990213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist