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General NPI Number Information
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NPI Number | 1194827543
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Entity Type | Individual
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Provider Name | JEFFREY MICHAEL LOCKHART MD
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15 HOSPITAL DR
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-351-2407
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Fax | 207-351-2193
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Provider Business Mailing Address
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Address Line | 41 MEADOW LN
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City | ELIOT
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State | ME
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Zip | 03903-2212
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Country | US
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Telephone | 207-451-9691
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Fax | 207-451-9129
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 015223
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License Number State | ME
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