Provider Demographics
NPI:1366257180
Name:WRIGHT, ARCHIE EUGENE
Entity type:Individual
Prefix:MR
First Name:ARCHIE
Middle Name:EUGENE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14028 MADISON CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4057
Mailing Address - Country:US
Mailing Address - Phone:402-659-3160
Mailing Address - Fax:402-953-4558
Practice Address - Street 1:14028 MADISON CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-4057
Practice Address - Country:US
Practice Address - Phone:402-659-3160
Practice Address - Fax:402-953-4558
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor