Provider Demographics
NPI:1326784232
Name:LIGHTNER, ARTHUR EUGENE JR (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:EUGENE
Last Name:LIGHTNER
Suffix:JR
Gender:M
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:MCMECHEN
Mailing Address - State:WV
Mailing Address - Zip Code:26040-1213
Mailing Address - Country:US
Mailing Address - Phone:304-231-4154
Mailing Address - Fax:
Practice Address - Street 1:613 GRANT ST
Practice Address - Street 2:
Practice Address - City:MCMECHEN
Practice Address - State:WV
Practice Address - Zip Code:26040-1213
Practice Address - Country:US
Practice Address - Phone:304-231-4154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty