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General NPI Number Information
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NPI Number | 1669584686
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Entity Type | Individual
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Provider Name | DWIGHT PAUL LIGHAM MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 1 LONG WHARF DRIVE SUITE 212
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 203-624-4208
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Fax | 203-624-4301
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Provider Business Mailing Address
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Address Line | 1 LONG WHARF DRIVE # 212 ADVANCED DIAGNOSTIC PAIN TREATMENT CENTER PC
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 203-624-4208
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Fax | 203-624-4301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 034195
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 034195
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 034195
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License Number State | CT
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