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General NPI Number Information
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NPI Number | 1205027315
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Entity Type | Individual
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Provider Name | JULIE ELLEN LOCKWOOD PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 8360 E RAINTREE DR STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2677
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Country | US
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Telephone | 480-766-3404
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Fax | 602-795-2445
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Provider Business Mailing Address
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Address Line | PO BOX 308
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-1806
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Country | US
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Telephone | 480-718-5400
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Fax | 877-666-4624
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10272
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4629
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License Number State | AZ
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