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General NPI Number Information
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NPI Number | 1780773416
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Entity Type | Organization
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Legal Business Name | VIRGINIA LIGHTNER FAMILY DERMATOLOGY, PA
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 82 WHEATON DR
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-8691
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Country | US
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Telephone | 919-562-8887
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Fax | 919-570-0211
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Provider Business Mailing Address
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Address Line | 82 WHEATON DR
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-8691
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Country | US
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Telephone | 919-562-8887
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Fax | 919-570-0211
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIRGINIA A LIGHTNER
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Credential | MD, PHD
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Telephone | 919-562-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 27232
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License Number State | NC
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