Basic Information
| Provider Information | |||||||||
| NPI: | 1386930519 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1086 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159054305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144108300 | ||||||||
| FaxNumber: | 8144108331 | ||||||||
| Practice Location | |||||||||
| Address1: | 4186 CORTLAND DR | ||||||||
| Address2: | BOX 367 | ||||||||
| City: | NEW PARIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 155547706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148394108 | ||||||||
| FaxNumber: | 8148394845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2011 | ||||||||
| LastUpdateDate: | 07/02/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD452340 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.