| 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 | 
|---|---|
| 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. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1326176983 PECOS PAC ID: 4688748452 Enrollment ID: O20080729000242 | 
| Entity Name | Genesis Health System | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1528616901 PECOS PAC ID: 6103829338 Enrollment ID: O20191031002622 | 
| Mailing Address | Practice Location Address | 
|---|---|
| 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 | |
| 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 |