Healthcare Provider Details

I. General information

NPI: 1639676406
Provider Name (Legal Business Name): WINTHROP CHARLES LOCKWOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE GME 13001 E. 17TH PLACE
AURORA CO
80045-2581
US

IV. Provider business mailing address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE GME 13001 E. 17TH PLACE
AURORA CO
80045-2581
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-2963
  • Fax: 303-724-1593
Mailing address:
  • Phone: 303-724-2963
  • Fax: 303-724-1593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberDR.0063157
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: