Healthcare Provider Details

I. General information

NPI: 1154584548
Provider Name (Legal Business Name): LOCKHEED MARTIN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 S COBB DR SE BLDG T660
MARIETTA GA
30063-0001
US

IV. Provider business mailing address

86 S COBB DR DEPT RE2M, ZONE 0454
MARIETTA GA
30063-0001
US

V. Phone/Fax

Practice location:
  • Phone: 770-494-1152
  • Fax: 770-494-7490
Mailing address:
  • Phone: 770-494-1152
  • Fax: 770-494-7490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLEECE S BARBER
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 301-548-2348