DR. BENJAMIN W LIGHT (NPI# 1760463632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760463632 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN W LIGHT |
| Credential | M.D., F.A.C.S. |
| Practice Address |
1218 13th Ave Se Decatur AL 35601-4307 |
| Practice Telephone | 2563556200 |
| Practice Fax Number | 2563556241 |
| Mailing Telephone | 2563556200 |
| Mailing Fax Number | 2563556241 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
00024976 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS | 515-12384 | 01 |
| AL | RAILROAD MEDICARE | CM6320 | 01 |
| AL | RAILROAD MEDICARE | P00017388 | 01 |
| AL | PROVIDER NUMBER | 051512384 | 01 |
| AL | 051512384 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447294483 | Benjamin Leroy Light | Technician/Technologist | 1318 W Candletree Dr, Suite 3, Peoria, IL 61614-8508 | 2006-06-16 |
| Street Address |
1218 13TH AVE SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-4307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265413124 | Sage Kinney Copeland | Otolaryngology | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2005-11-08 |
| 1215445937 | Shawna Marie Cadarette | Physical Therapist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2018-01-16 |
| 1851833776 | Sung D Kim | Physical Therapist | 1218 13th Ave Se, Decatur, AL 35601 | 2016-11-09 |
| 1871948935 | Frank Fischer | Hearing Instrument Specialist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2016-04-26 |
| 1982876520 | Randall Wilks | Audiologist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2008-03-24 |
| 1164487708 | Decatur Ent Assoc., P.C. | Otolaryngology | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2006-04-18 |
| 1558342931 | George H Godwin IIi | Otolaryngology | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2005-11-11 |
| 1295716975 | Kathryn Sulcer | Physical Therapist | 1218 13th Ave Se, Decatur, AL 35601-4307 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174628572 | Azhar Aslam Md LLC | Otolaryngology | 1770 E Lake Shore Dr, Suite 103, Decatur, IL 62521-3832 | 2006-09-13 |
| 1922057371 | Azhar Aslam | Otolaryngology | 1770 E Lake Shore Dr, Suite 103, Decatur, IL 62521-3832 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881019537 | South Otolaryngology-head and Neck Surgery, LLC | Otolaryngology | 2126 W Roy Parker Rd Ste 207, Ozark, AL 36360-8566 | 2014-03-04 |
| 1649523044 | Core Ent. LLC | Otolaryngology | 215 South 5th Street, Gadsden, AL 35901-4217 | 2012-10-23 |
| 1710241054 | Ryan Gegg | Otolaryngology | 112 Haven Dr Ste 1, Dothan, AL 36301-2908 | 2012-07-02 |
| 1528075447 | Southeast Alabama Ent Head & Neck | Otolaryngology | 1118 Rose Clark Circle, Ste 210, Dothan, AL 36301 | 2006-08-02 |
| 1811913544 | Kurt W Kantzler | Otolaryngology | 215 S 5th St, Gadsden, AL 35901-4217 | 2006-07-14 |
| 1538195961 | Blane Edward Bateman | Otolaryngology | 901 Leighton Avenue, Suite 506, Anniston, AL 36207 | 2006-06-25 |
| 1497794945 | Marcus Moody | Otolaryngology | 2116 Data Park, Hoover, AL 35244-1203 | 2006-06-06 |
| 1063467447 | John H Rand | Otolaryngology | 80 Herren Hill Road, Ste D, Tallassee, AL 36078 | 2006-05-23 |
| 1477507408 | Mark L Hagood | Otolaryngology | 201 Whitesport Dr Sw, Huntsville, AL 35801-6449 | 2006-05-22 |
| 1316924798 | Salem K David Jr. | Otolaryngology | 1224 Mcfarland Blvd Ne, Suite A, Tuscaloosa, AL 35406-2287 | 2005-12-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.