Provider Demographics
NPI:1477683191
Name:LIGHTNER, DONITA DILLON (MD)
Entity Type:Individual
Prefix:DR
First Name:DONITA
Middle Name:DILLON
Last Name:LIGHTNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 OLD TOWNE WALK
Mailing Address - Street 2:APT. 8101
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-2020
Mailing Address - Country:US
Mailing Address - Phone:859-576-9056
Mailing Address - Fax:
Practice Address - Street 1:149 OLD TOWNE WALK APT 8101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2197
Practice Address - Country:US
Practice Address - Phone:859-576-9056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY453592084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100202980Medicaid
KY7100202980Medicaid