Individual
JILL L. LIGHTFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4700 E 56TH ST STE 100, DAVENPORT, IA 52807-2904
(563) 421-9100
(563) 421-9129
Mailing address
4700 E 56TH ST STE 100, DAVENPORT, IA 52807-2904
(563) 421-9100
(563) 421-9129
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
39362
IA
207N00000X
Dermatology Physician
R8125
IA
207R00000X
Internal Medicine Physician
R8125
IA
Other
Enumeration date
06/20/2007
Last updated
09/20/2024
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