Provider Demographics
NPI:1669432290
Name:WRIGHT, GAIL LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:LYNN
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-274-8200
Practice Address - Street 1:7651 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6594
Practice Address - Country:US
Practice Address - Phone:727-868-9208
Practice Address - Fax:727-868-6420
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71516207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01030364OtherFCS RAILROAD MEDICARE
FLP00074422OtherRAILROAD MEDICARE
FL269001200Medicaid
FL26376XMedicare PIN
FLP00074422OtherRAILROAD MEDICARE
FL269001200Medicaid