Basic Information
| Provider Information | |||||||||
| NPI: | 1558325738 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIGHTNER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228031430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405645791 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 752 OTT ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228013214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405647007 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 04/03/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 0101039318 | VA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | O88973 | 01 | SENTARA | OTHER | 1804803000 | 01 | WV | WV MEDICAID | OTHER | 264872 | 01 | ANTHEM/BCBS | OTHER | 97287 | 01 | CIGNA BEHAVIORAL HEALTH | OTHER | 260039341 | 01 | RAILROAD MEDICARE | OTHER | 88973 | 01 | VA | OPTIMA | OTHER | 1000870001 | 01 | VA | DME PROVIDER | OTHER | 187234 | 01 | COMPSYCH | OTHER | 012462 | 01 | VALUE OPTIONS | OTHER | 7111371 | 05 | VA | MEDICAID |