Healthcare Provider Details

I. General information

NPI: 1710942131
Provider Name (Legal Business Name): CINDY ANN LOCKETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 MEDICAL CENTER POINT
COLORADO SPRINGS CO
80907
US

IV. Provider business mailing address

2 SOUTH CASCADE AVENUE SUITE 140
COLORADO SPRINGS CO
80903-1604
US

V. Phone/Fax

Practice location:
  • Phone: 719-636-2999
  • Fax: 719-667-4108
Mailing address:
  • Phone: 719-538-2900
  • Fax: 719-538-2961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36252
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0052715
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: