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Individual

DR. WILLIAM LIGHTHART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
555 E BROADWAY AVE, JACKSON, WY 83001-8640
(307) 733-3900
(307) 732-0925
Mailing address
PO BOX 10490, JACKSON, WY 83002-0490
(307) 733-3900
(307) 732-0925

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
036115858
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336221712
830322741
WY
01
83-0322741
1336221712
WY
Enumeration date
05/26/2006
Last updated
02/19/2021
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