Provider Demographics
NPI:1699959395
Name:WRIGHT, RONALD KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:KEITH
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 W STATE ROAD 84
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-4808
Mailing Address - Country:US
Mailing Address - Phone:954-581-7952
Mailing Address - Fax:
Practice Address - Street 1:1000 DUCKS NEST RD
Practice Address - Street 2:
Practice Address - City:TURTLETOWN
Practice Address - State:TN
Practice Address - Zip Code:37391-4678
Practice Address - Country:US
Practice Address - Phone:423-496-4813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 21426202C00000X
TNMD0000036065202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner