Basic Information
| Provider Information | |||||||||
| NPI: | 1346349362 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 94220 4TH ST | ||||||||
| Address2: | ANNEX | ||||||||
| City: | GOLD BEACH | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974447756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412473000 | ||||||||
| FaxNumber: | 5412473101 | ||||||||
| Practice Location | |||||||||
| Address1: | 94244 4TH ST | ||||||||
| Address2: | |||||||||
| City: | GOLD BEACH | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974447756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412473155 | ||||||||
| FaxNumber: | 5412473530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 04/05/2011 | ||||||||
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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 | 207X00000X | E2953 | TX | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD28914 | OR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 20-1596824 | 01 | OR | RUSH SURGERY CENTER, LLC - TAX I.D. | OTHER | 1346486818 | 01 | OR | CURRY MEDICAL PRACTICE NPI | OTHER | 1518290642 | 01 | OR | RUSH MEDICAL CLINIC NPI | OTHER | 381322 | 01 | OR | CURRY GENERAL HOSPITAL - MEDICARE PART A | OTHER | 500624052 | 01 | OR | RUSH MEDICAL CLINIC - MEDICAID | OTHER | 93-0937095 | 01 | OR | CURRY HEALTH DISTRICT TAX I.D. | OTHER | 1164452249 | 01 | OR | RUSH SURGER CENTER, LLC NPI | OTHER | 0000AGBDG | 01 | OR | RUSH MEDICAL CLINIC - MEDICARE PART B | OTHER | 0000ZGBDG | 01 | OR | CURRY MEDICAL PRACTICE - MEDICARE PART B | OTHER | 240088 | 01 | OR | RUSH SURGERY CENTER, LLC - MEDICAID | OTHER | 134825 | 01 | OR | RUSH SURGERY CENTER, LLC - MEDICARE | OTHER | 500603114 | 05 | OR | MEDICAID |