Provider Demographics
NPI:1891031019
Name:WRIGHT, MANJIT K (PA-C)
Entity type:Individual
Prefix:
First Name:MANJIT
Middle Name:K
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MANJIT
Other - Middle Name:
Other - Last Name:GIDDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9250 W THOMAS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3382
Mailing Address - Country:US
Mailing Address - Phone:623-322-5900
Mailing Address - Fax:623-889-7286
Practice Address - Street 1:9250 W THOMAS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3382
Practice Address - Country:US
Practice Address - Phone:623-322-5900
Practice Address - Fax:623-889-7286
Is Sole Proprietor?:No
Enumeration Date:2012-12-15
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5313363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant