Basic Information
| Provider Information | |||||||||
| NPI: | 1801836259 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIGHTFORD | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 FRENCH LANDING DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372281511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152549981 | ||||||||
| FaxNumber: | 6152549747 | ||||||||
| Practice Location | |||||||||
| Address1: | 131 FRENCH LANDING DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372281511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152549981 | ||||||||
| FaxNumber: | 6152549747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 10/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 19090 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3106714 | 01 | TN | BLUECROSS BLUESHIELD | OTHER | 3863549 | 05 | TN | MEDICAID | 4299783 | 01 | TN | BLUE CROSS-BLUE SHIELD | OTHER | P01014347 | 01 | TN | RR MEDICARE | OTHER | 4236106 | 01 | TN | AETNA | OTHER |