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General NPI Number Information
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NPI Number | 1003855339
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Entity Type | Individual
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Provider Name | GREGORY R LOCKHART MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 593 EDDY ST CLAVERICK 2
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City | PROVIDENCE
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State | RI
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Zip | 02903-4923
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Country | US
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Telephone | 401-444-4000
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Fax | 401-427-7795
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Provider Business Mailing Address
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Address Line | PO BOX 9484
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City | PROVIDENCE
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State | RI
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Zip | 02940-9484
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Country | US
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Telephone | 401-854-2500
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Fax | 401-854-2519
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | MD08011
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | MD08011
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License Number State | RI
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