Provider Demographics
NPI:1558325738
Name:LIGHTNER, JEFFREY K (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:K
Last Name:LIGHTNER
Suffix:
Gender:M
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:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-5791
Mailing Address - Fax:
Practice Address - Street 1:752 OTT ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3214
Practice Address - Country:US
Practice Address - Phone:540-564-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010393182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
O88973OtherSENTARA
WV1804803000OtherWV MEDICAID
264872OtherANTHEM/BCBS
97287OtherCIGNA BEHAVIORAL HEALTH
260039341OtherRAILROAD MEDICARE
VA88973OtherOPTIMA
VA1000870001OtherDME PROVIDER
187234OtherCOMPSYCH
012462OtherVALUE OPTIONS
VA7111371Medicaid
264872OtherANTHEM/BCBS
O88973OtherSENTARA
VA7111371Medicaid