Light, Diane Louise
Light, Diane Louise is an individual health care provider with primary practice located at 1125 Madison St , Jefferson City MO 65101-5227. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Light, Diane Louise can be contacted via phone (573) 632-5700.Contact Information
Primary practice address
1125 Madison St
Jefferson City MO 65101-5227
Phone: (573) 632-5700
Fax: (573) 632-5720
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 100575 | Missouri |
Profile Details
| NPI number | 1831185651 |
|---|---|
| LBN Legal business name | Light, Diane Louise |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Aug 10th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831185651 | NPPES |
| Missouri | Other | 020038004 | RAILROAD MEDICARE |
| Missouri | MEDICAID | 243392222 | RAILROAD MEDICARE |
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