Provider Demographics
NPI:1992881080
Name:WRIGHT, WYCLIFFE LEON (MD)
Entity type:Individual
Prefix:DR
First Name:WYCLIFFE
Middle Name:LEON
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 1:2001 CHARLOTTE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2032
Mailing Address - Country:US
Mailing Address - Phone:615-327-4600
Mailing Address - Fax:615-327-4608
Practice Address - Street 1:2001 CHARLOTTE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2032
Practice Address - Country:US
Practice Address - Phone:615-327-4600
Practice Address - Fax:615-327-4608
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30126207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3823527Medicaid
TN3823527Medicare ID - Type UnspecifiedMEDICARE NUMBER
TN3823527Medicaid