Jill L Lightfoot, MD | |
4700 E 56th St Ste 100, Davenport, IA 52807-2904 | |
(563) 421-9100 | |
(563) 421-9129 |
Full Name | Jill L Lightfoot |
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Gender | Female |
Speciality | Dermatology |
Location | 4700 E 56th St Ste 100, Davenport, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609071364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | R8125 (Iowa) | Secondary |
207R00000X | Internal Medicine | R8125 (Iowa) | Secondary |
207N00000X | Dermatology | 39362 (Iowa) | Primary |
Entity Name | Accredited Dermatology Associates, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326176983 PECOS PAC ID: 4688748452 Enrollment ID: O20080729000242 |
Mailing Address | Practice Location Address |
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Jill L Lightfoot, MD 4700 E 56th St Ste 100, Davenport, IA 52807-2904 Ph: (563) 421-9100 | Jill L Lightfoot, MD 4700 E 56th St Ste 100, Davenport, IA 52807-2904 Ph: (563) 421-9100 |
Dr. William Colantoni Jr., MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 100 E Kimberly Rd, Suite 303, Davenport, IA 52806 Phone: 563-386-3333 Fax: 563-386-9209 | |
Dr. John Allen Bovenmyer, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3319 Spring St, Suite 102, Davenport, IA 52807 Phone: 563-359-1671 Fax: 563-359-7813 | |
Austin John Maddy, Dermatology Medicare: Medicare Enrolled Practice Location: 4700 E 56th St Ste 100, Davenport, IA 52807 Phone: 634-219-1005 Fax: 563-421-9109 | |
Jordan Brady Evans, MD Dermatology Medicare: May Accept Medicare Assignments Practice Location: 1950 E 54th St, Davenport, IA 52807 Phone: 563-344-7546 Fax: 563-344-1373 | |
Dr. Robert F. Godwin, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2322 E Kimberly Rd, Suite N100, Davenport, IA 52807 Phone: 563-355-3376 | |
Dr. Ravindrakumar Gangadhariah, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4624 Progress Drive Ste D, Davenport, IA 52807 Phone: 563-355-0015 Fax: 563-355-0013 |