Individual
TIMOTHY D LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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