Provider Demographics
NPI:1760659684
Name:LIGHTNER, JOEL E JR (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:E
Last Name:LIGHTNER
Suffix:JR
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 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-415-1660
Mailing Address - Fax:251-415-1016
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012530642085R0202X
AL335842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL214423Medicaid
AL214687Medicaid
AL245107Medicaid
AL213719Medicaid
AL213926Medicaid
AL244495Medicaid
AL244497Medicaid
AL214691Medicaid
AL244606Medicaid
AL214690Medicaid
AL215002Medicaid
AL241761Medicaid
AL244751Medicaid
AL215117Medicaid