Provider Demographics
NPI:1699810747
Name:LIGHTFOOTE, LYNNE J (MD)
Entity type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:J
Last Name:LIGHTFOOTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE STE 1005
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6917
Mailing Address - Country:US
Mailing Address - Phone:301-968-6080
Mailing Address - Fax:833-438-4270
Practice Address - Street 1:5454 WISCONSIN AVE STE 1005
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6917
Practice Address - Country:US
Practice Address - Phone:301-968-6080
Practice Address - Fax:833-438-4270
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035589174400000X, 207V00000X
VA0101285714207V00000X
MDD0102649207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist