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General NPI Number Information
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NPI Number | 1295992089
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Entity Type | Individual
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Provider Name | MEREDITH BROOKE WATSON LOCKLEAR M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 1111 W FAIRBANKS AVE FL 2
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City | WINTER PARK
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State | FL
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Zip | 32789-4720
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Country | US
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Telephone | 407-635-3024
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Fax | 321-203-4626
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Provider Business Mailing Address
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Address Line | 1111 W FAIRBANKS AVE FL 2
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City | WINTER PARK
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State | FL
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Zip | 32789-4720
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Country | US
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Telephone | 407-635-3024
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Fax | 321-203-4626
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 200800789
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME132738
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License Number State | FL
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