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Individual

TIMOTHY D LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
510 E BLOOMINGTON ST, IOWA CITY, IA 52245-2803
(319) 338-9247
(319) 338-2785
Mailing address
510 E BLOOMINGTON ST, IOWA CITY, IA 52245-2803
(319) 338-9247
(319) 338-2785

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
36893
IA
2086S0102X
Surgical Critical Care Physician
MD33292
DC
2086S0127X
Trauma Surgery Physician
Primary
36893
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0743179
IA
01
27811
WELLMARK BCBS
IA
Enumeration date
11/04/2005
Last updated
04/27/2012
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