Individual
MICHAEL JOHN LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1108 MAIN STREET, SHELBYVILLE, KY 40065
(502) 513-5058
(502) 513-5215
Mailing address
1108 MAIN STREET, SHELBYVILLE, KY 40065
(502) 513-5058
(502) 513-5215
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01056762A
IN
2084P0800X
Psychiatry Physician
Primary
36355
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2003610101A
—
IL
05
—
64038847
—
KY
Enumeration date
07/05/2005
Last updated
04/07/2020
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