MEDICARE: MARIE LOCKARD PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1558844134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE LOCKARD PA-C

Provider Business Mailing Address
First Line	:	2405 ATHERHOLT RD
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24501-2184
Country	:	US
Telephone Number	:	434-485-8500
Fax Number	:	434-485-8599

Provider Business Practice Location Address
First Line	:	301 SAINT PAUL ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-2102
Country	:	US
Telephone Number	:	410-539-2227
Fax Number	:	410-539-2240

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	03/11/2026

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Directions to “ MARIE LOCKARD PA-C” Practice Location

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