Kevin Theodore Wright (NPI# 1164700738, PAC ID# 3678803814) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1164700738 |
| PAC ID by PECOS | 3678803814 |
| Professional Enrollment ID | I20191001001945 |
| Full Name | Kevin Theodore Wright |
| Organization Legal Name | CLINIC FOR DERMATOLOGY AND WELLNESS LLC |
| Address |
2924 Siskiyou Blvd Suite 200 Medford OR 97504-6462 |
| Phone Number | 5419411007 |
| Gender | M |
| Medical School | UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES |
| Graduation Year | 2011 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 5890083729 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 | 5419411007 | CLINIC FOR DERMATOLOGY AND WELLNESS LLC |
| Organization Legal Name | CLINIC FOR DERMATOLOGY AND WELLNESS LLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica Babbitt Hulcy | Nurse Practitioner | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Nikki D Tang | Dermatology | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Joseph Rocco Gatti | Physician Assistant | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Elena Tovkan Forster | Physician Assistant | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Street Address |
2924 SISKIYOU BLVD SUITE 200 |
| City | MEDFORD |
| State | OR |
| Zip | 97504-6462 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly M Schneider | Physician Assistant | Redding Dermatology Medical Group, Inc. | 2924 Siskiyou Blvd, Suite 100, Medford, OR 97504-8194 |
| Jessica Babbitt Hulcy | Nurse Practitioner | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Nikki D Tang | Dermatology | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Joseph Rocco Gatti | Physician Assistant | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Elena Tovkan Forster | Physician Assistant | Clinic for Dermatology and Wellness LLC | 2924 Siskiyou Blvd, Suite 200, Medford, OR 97504-6462 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Anne Zaslow | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Benjamin Robert Oldson | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Shirley A Malcolm | Osteopathic Manipulative Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Denise M Viss | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Carissa D Scalf | Psychologist, Clinical | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Wesley T Ramoso | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Uzomechine Thabiso Chiedozi | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Grant A Jolliffe | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Travis Adam Day | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Jasmin Williams | Clinical Social Worker | Options for Southern Oregon | 1700 E Barnett Rd, Medford, OR 97504-0052 |
| Find all physicians in zip 97504 | |||
| City | MEDFORD |
| Zip Code | 97504 |
| Specialty | DERMATOLOGY |
| City + Specialty | MEDFORD + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.