Healthcare Provider Details

I. General information

NPI: 1013940881
Provider Name (Legal Business Name): LOCKHART CHIROPRACTIC CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 S TOLEDO AVE
TULSA OK
74137-2727
US

IV. Provider business mailing address

9225 S TOLEDO AVE
TULSA OK
74137-2727
US

V. Phone/Fax

Practice location:
  • Phone: 918-749-8888
  • Fax: 918-499-8878
Mailing address:
  • Phone: 918-749-8888
  • Fax: 918-499-8878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2506
License Number StateOK

VIII. Authorized Official

Name: DR. BARRY A LOCKHART
Title or Position: OWNER/DOCTOR
Credential: DC
Phone: 918-749-8888