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Individual

DR. JIMMY LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 IRVING ST NW, SUITE 3D - 31, WASHINGTON, DC 20010-2976
(202) 877-6029
Mailing address
4204 ROSEMARY ST, CHEVY CHASE, MD 20815-5218
(301) 657-3113

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
MD25560
DC
208600000X
Surgery Physician
MD25560
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007305818
DC
05
025597100
DC
05
327801200
DC
Enumeration date
01/24/2006
Last updated
06/27/2008
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