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NPI Code Detail

MEDICARE: ALEXIS D LIGHT MD

MEDICARE: ALEXIS D LIGHT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VX0000XObstetrics PhysicianMD045985DC
2207VX0000XObstetrics Physician0101264717VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10101264717OTHERVASTATE LICENSE

General Provider Information

NPI Number : 1144648502
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS D LIGHT MD
Provider Business Mailing Address
First Line : 700 S WASHINGTON ST STE 330
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-4252
Country : US
Telephone Number : 703-940-3364
Fax Number : 703-717-4055
Provider Business Practice Location Address
First Line : 700 S WASHINGTON ST STE 330
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-4252
Country : US
Telephone Number : 703-940-3364
Fax Number : 703-717-4055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2014
Last Update Date : 03/26/2025

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