Individual provider Active NPI

Clarence David Wright, MD

  • Family Medicine Physician
  • Oscoda, MI
National Provider Identifier
1033107875
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301042906 Issued in MI
Practice address
5939 N Huron Rd
Oscoda, MI 48750-9710
Phone
(989) 739-1441
Fax
(989) 739-6093
NPI assigned
Oct 6, 2005
Last updated
May 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301042906 MI Primary

Addresses

Primary practice location

5939 N Huron Rd
Oscoda, MI 48750-9710

Mailing address

PO Box 779
Tawas City, MI 48764-0779
Phone (989) 362-0153

Other identifiers 1

IdentifierTypeStateIssuer
2854238MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1033107875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487640779",
            "telephone_number": "989-362-0153",
            "fax_number": "989-362-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 N HURON RD",
            "city": "OSCODA",
            "state": "MI",
            "postal_code": "487509710",
            "telephone_number": "989-739-1441",
            "fax_number": "989-739-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "CLARENCE",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301042906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2854238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oscoda, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.