Provider Demographics
NPI:1861416794
Name:WRIGHT, WILLIAM ARTHUR (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 IZARD CT.
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414
Mailing Address - Country:US
Mailing Address - Phone:843-402-9848
Mailing Address - Fax:
Practice Address - Street 1:109 BEE STREET
Practice Address - Street 2:RALPH H. JOHNSON VAMC
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401
Practice Address - Country:US
Practice Address - Phone:843-789-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA185P363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1006560OtherNCCPA CERTIFICATION #
SCA185POtherPHYSICIAN ASSISTANT LIC.