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General NPI Number Information
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NPI Number | 1538318340
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Entity Type | Individual
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Provider Name | CODY REED LOCKHART DDS
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Gender | Male
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 26496 MIDLAND TRAIL
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City | HICO
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State | WV
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Zip | 25854
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Country | US
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Telephone | 304-658-5282
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Fax | 304-658-5299
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | HICO
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State | WV
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Zip | 25854
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Country | US
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Telephone | 304-658-5282
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Fax | 304-658-5299
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3823
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License Number State | WV
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