MEDICARE: MR. DOUGLAS F TIGHT PA

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
1	363AM0700X	Medical Physician Assistant	3407	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376593509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DOUGLAS F TIGHT PA

Provider Business Mailing Address
First Line	:	1104 ENISWOOD PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-2022
Country	:	US
Telephone Number	:	727-459-9677
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 ENISWOOD PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-2022
Country	:	US
Telephone Number	:	727-459-9677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/24/2021

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