Provider Demographics
NPI:1821442682
Name:GOLIGHTLY, CAMERON EDWARD (DO)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:EDWARD
Last Name:GOLIGHTLY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 N LYERLY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2743
Mailing Address - Country:US
Mailing Address - Phone:423-826-8000
Mailing Address - Fax:
Practice Address - Street 1:251 N LYERLY ST STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2743
Practice Address - Country:US
Practice Address - Phone:423-826-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA88196207RN0300X
390200000X
TN4341207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program