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NPI Code Detail

MEDICARE: JUSTIN KIGHT

MEDICARE: JUSTIN KIGHT
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
1106S00000XBehavior Technician1737095IN

General Provider Information

NPI Number : 1437798857
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN KIGHT
Provider Business Mailing Address
First Line : 3216 BALLARD LN
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-7200
Country : US
Telephone Number : 812-590-2157
Fax Number : 812-645-3936
Provider Business Practice Location Address
First Line : 3216 BALLARD LN
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-7200
Country : US
Telephone Number : 812-590-2157
Fax Number : 812-645-3936
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2020
Last Update Date : 01/02/2020

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Directions to “ JUSTIN KIGHT ” Practice Location

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