Basic Information
| Provider Information | |||||||||
| NPI: | 1235310947 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1950 OLD GALLOWS RD | ||||||||
| Address2: | STE 520 | ||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221823970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038478899 | ||||||||
| FaxNumber: | 7039910514 | ||||||||
| Practice Location | |||||||||
| Address1: | 5530 WINDWARD PKWY | ||||||||
| Address2: | BUILDING D, SUITE 420 | ||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300048969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703468076 | ||||||||
| FaxNumber: | 7703460850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2007 | ||||||||
| LastUpdateDate: | 02/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPT001826 | GA | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 2042 | CO | N | Eye and Vision Services Providers | Optometrist | 152WC0802X | OPT001826 | GA | Y | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152WC0802X | 2042 | CO | N | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management |
No ID Information.