| Wright Medical Care Pllc | |
|
5422 Creek View Ln Edina MN 55439-1310 | |
| (952) 835-6465 | |
| (952) 835-6423 |
| Full Name | Wright Medical Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5422 Creek View Ln, Edina, Minnesota |
| Authorized Official Name and Position | Louise G Wright (CHIEF MANAGER) |
| Authorized Official Contact | 9528356465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wright Medical Care Pllc Po Box 398013 Edina MN 55439-8013 Ph: (952) 835-6465 | Wright Medical Care Pllc 5422 Creek View Ln Edina MN 55439-1310 Ph: (952) 835-6465 |
| NPI Number | 1538205208 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 12/22/2017 |
| Medicare PECOS PAC ID | 4082716865 |
|---|---|
| Medicare Enrollment ID | O20070226000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538205208 | NPI | - | NPPES |
| 1265496095 | Other | MN | PROVIDER NPI # |
| 1790 | Other | MN | REGISTRATION # |
| C05581 | Other | MN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 39461 (Minnesota) | Primary |
| Provider Name | Louise Gearhart Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265496095 PECOS PAC ID: 4688667678 Enrollment ID: I20040406000527 |
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