GEORGE A LIGHTBOURN MD PC (NPI# 1083887822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083887822 |
| Entity Type | Organization |
| Organization Name | GEORGE A LIGHTBOURN MD PC |
| Practice Address |
29600 Northwestern Hwy Suite 104 Southfield MI 48034-1016 |
| Mailing Address |
Po Box 937 Southfield MI 48037-0937 |
| Practice Telephone | 2483536599 |
| Practice Fax Number | 2483536566 |
| Mailing Telephone | 2483536599 |
| Mailing Fax Number | 2483536566 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2013-12-11 |
| Authorized Official Name | DR. GEROGE A LIGHTBOURN (PRESIDENT) |
| Authorized Official Telephone | 2483536599 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 101346646 | 05 | |
| WELLNESS PLAN | 1123970001 | 01 | |
| BLUE CROSS BLUE SHIELD | 3408257131 | 01 | |
| BLUE CARE NETWORK | 3408257131 | 01 |
| Street Address |
29600 NORTHWESTERN HWY SUITE 104 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48034-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245264209 | Andrea Celeste Lightbourn | Obstetrics & Gynecology | 29600 Northwestern Hwy, 104, Southfield, MI 48034-1016 | 2006-07-10 |
| 1497260871 | Group Psychotherapy, PC | Psychiatry & Neurology | 29600 Northwestern Hwy, 100b, Southfield, MI 48034-1016 | 2017-12-07 |
| 1235520339 | The Chair | Counselor | 29600 Northwestern Hwy, Ste 100, Southfield, MI 48034-1016 | 2015-02-10 |
| 1336447028 | David A Baker | Social Worker | 29600 Northwestern Hwy, Suite 100, Southfield, MI 48034-1016 | 2011-03-04 |
| 1487955845 | Ultra Diagnostic Services PC | Nuclear Medicine | 29600 Northwestern Hwy, Suite 106, Southfield, MI 48034-1016 | 2010-11-16 |
| 1972814689 | Ronald Jacob Hook | Social Worker | 29600 Northwestern Hwy, Suite #100a, Southfield, MI 48034-1016 | 2010-06-28 |
| 1649429499 | Paul Poisel Shultz | Social Worker | 29600 Northwestern Hwy, #115, Southfield, MI 48034-1016 | 2008-09-17 |
| 1720255987 | Andrea C Lightbourn Md Pllc | Specialist | 29600 Northwestern Hwy, 104, Southfield, MI 48034-1016 | 2008-05-15 |
| 1962680587 | Natan Harpaz | Social Worker | 29600 Northwestern Hwy, Suite 103, Southfield, MI 48034-1016 | 2008-02-06 |
| 1386771087 | Leora Pnina Bar-levav | Counselor | 29600 Northwestern Hwy, Suite 100, Southfield, MI 48034-1016 | 2007-02-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780219196 | I. R. Horn & Associates LLC | Community/Behavioral Health | 29623 Norhtwestern Hwy Suite 5, Southfield, MI 48034 | 2020-03-05 |
| 1003378753 | Alexis Shivers | Physical Therapy Assistant | 27500 Lahser Rd, Southfield, MI 48034 | 2019-04-02 |
| 1598257768 | El-abbadi Pediatric Clinic | Pediatrics | 24676 Lahser Road, Southfield, MI 48034 | 2018-06-04 |
| 1689166894 | Recore Rehabilitation Services | Clinic/Center | 25899 W 12 Mile Rd # 340, Southfield, MI 48034 | 2018-06-04 |
| 1578063749 | El-abbadi Healthcare Center | Clinic/Center | 27403 Lahser Rd, Southfield, MI 48034 | 2018-02-14 |
| 1063924819 | Diagnostic Hematology, PC | Clinical Medical Laboratory | 24725 W. Twelve Mile Road, Suite 118, Southfield, MI 48034 | 2017-11-02 |
| 1962929125 | Toms Holistic Home Visits Pllc | Clinic/Center | 28675 Franklin Rd, Suite 217, Southfield, MI 48034 | 2017-08-28 |
| 1265956940 | Abbadi Healthcare | Pharmacy | 27402 Lahser Road, Southfield, MI 48034 | 2017-08-03 |
| 1720517113 | Theramedic Home Health Care LLC | Home Health | 26400 W. 12 Mile Rd, Suite 80, Southfield, MI 48034 | 2017-06-08 |
| 1538695804 | Adrienne Rutherford | Occupational Therapist | 25999 Franklin Pointe Dr, Southfield, MI 48034 | 2017-05-05 |
| Find all providers in zip 48034 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912324211 | Boston Medical Group, P.C. | Urology | 24901 Northwestern Hwy., Suite 615, Southfield, MI 48075 | 2014-03-25 |
| 1851592489 | Melvin L. Hollowell, M.d., F.a.c.s. | Urology | 20905 Greenfield Rd Ste 507, Southfield, MI 48075-5351 | 2007-05-30 |
| 1538334768 | Marc S Arnkoff M D and Gregory L. Weigler D O P C | Urology | 26400 W 12 Mile Rd, Suite 70, Southfield, MI 48034-1700 | 2008-04-29 |
| 1578750006 | Tewodros Fesseha, M.d., P.C. | Urology | 20905 Greenfield Rd, Suite 407, Southfield, MI 48075-5360 | 2007-09-28 |
| 1063625382 | Preferred Urology Consultants, P.c | Urology | 29201 Telegraph Rd, Suite 460, Southfield, MI 48034-1331 | 2007-05-07 |
| 1558411512 | Michigan Urological Institute | Urology | 22250 Providence Dr, Suite 203, Southfield, MI 48075-4825 | 2007-01-11 |
| 1639241441 | Melvin Laverne Hollowell | Urology | 20905 Greenfield, #507, Southfield, MI 48075 | 2006-11-15 |
| 1285643148 | George A Lightbourn | Urology | 29600 Northwestern Hwy, Suite 104, Southfield, MI 48034-1016 | 2006-08-07 |
| 1528011830 | Jeffrey Lawrence O'connor | Urology | 22250 Providence Dr, Suite 203, Southfield, MI 48075-4825 | 2006-05-18 |
| 1336192400 | James Bernard Smith Jr. | Urology | 22250 Providence Dr, Suite 203, Southfield, MI 48075-4825 | 2006-05-18 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48034 |
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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.