Organization
LIGHT PSYCHIATRIC SERVICES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN LIGHT MD (CEO)
(502) 244-5437
Entity
Organization
Contact information
Practice address
13113 EASTPOINT PARK BLVD, SUITE D, LOUISVILLE, KY 40223-4191
(502) 244-5437
(502) 244-5003
Mailing address
13113 EASTPOINT PARK BLVD, SUITE D, LOUISVILLE, KY 40223-4191
(502) 244-5437
(502) 244-5003
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
36355
KY
Other
Enumeration date
12/22/2006
Last updated
08/22/2020
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