Provider Demographics
NPI:1922039809
Name:WRIGHT, BRIAN RICHARD (DPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:RICHARD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:4788 FINLAY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2754
Mailing Address - Country:US
Mailing Address - Phone:804-222-4949
Mailing Address - Fax:804-226-0678
Practice Address - Street 1:4788 FINLAY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2754
Practice Address - Country:US
Practice Address - Phone:804-222-4949
Practice Address - Fax:804-226-0678
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0103000393213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009301259Medicaid
VAU00906Medicare UPIN
VA009301259Medicaid