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General NPI Number Information
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NPI Number | 1740348127
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Entity Type | Individual
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Provider Name | JOHN K LIGHTFOOT MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 950 W WOOSTER ST WOOD COUNTY HOSPITAL EMERGENCY DEPT.
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2603
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Country | US
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Telephone | 419-373-7642
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 PEARL ST
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2663
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301078778
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 214923
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 88893
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License Number State | OH
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