Provider Demographics
NPI:1801836259
Name:LIGHTFORD, CAROLYN Y (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:Y
Last Name:LIGHTFORD
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 1:131 FRENCH LANDING DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1511
Mailing Address - Country:US
Mailing Address - Phone:615-254-9981
Mailing Address - Fax:615-254-9747
Practice Address - Street 1:131 FRENCH LANDING DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1511
Practice Address - Country:US
Practice Address - Phone:615-254-9981
Practice Address - Fax:615-254-9747
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19090207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01014347OtherRR MEDICARE
TN3106714OtherBLUECROSS BLUESHIELD
TN3863549Medicaid
TN4299783OtherBLUE CROSS-BLUE SHIELD
TN4236106OtherAETNA
TN103I089202Medicare PIN
TNP01014347OtherRR MEDICARE
TN3863549Medicare PIN