Healthcare Provider Details

I. General information

NPI: 1073744017
Provider Name (Legal Business Name): DR. MIKE LOCKHART, JR. & ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 LINCOLN WAY E
MASSILLON OH
44646-6833
US

IV. Provider business mailing address

1151 MELSCHEIMER RD SW
EAST SPARTA OH
44626-9752
US

V. Phone/Fax

Practice location:
  • Phone: 330-833-1091
  • Fax: 330-833-1092
Mailing address:
  • Phone: 330-833-1091
  • Fax: 330-833-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LOCKHART JR.
Title or Position: OPTOMETRIST OWNER
Credential: O.D.
Phone: 330-833-1091