Provider Demographics
NPI:1730171190
Name:BRIGHT, JOHN R (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 281 WEST
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-759-9800
Mailing Address - Fax:270-762-1525
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:SUITE 281 WEST
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-759-9800
Practice Address - Fax:270-762-1525
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2010-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY02198207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64021983Medicaid
1476901Medicare ID - Type Unspecified
KY64021983Medicaid