Basic Information
| Provider Information | |||||||||
| NPI: | 1336574250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | BROOKS | ||||||||
| MiddleName: | EVERETT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1817 WINCANTON DR | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891346172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4077605981 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7391 W CHARLESTON BLVD STE 140 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891171577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028234255 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2013 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | DO2205 | NV | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.