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General NPI Number Information
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NPI Number | 1710082284
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Entity Type | Individual
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Provider Name | SPENCER S LOCKSON DPM
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 2725 CAPITOL AVE SUITE 302
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City | SACRAMENTO
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State | CA
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Zip | 95816-6004
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Country | US
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Telephone | 916-262-9464
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Fax | 916-262-9468
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Provider Business Mailing Address
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Address Line | 10470 OLD PLACERVILLE RD SUITE 100
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City | SACRAMENTO
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State | CA
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Zip | 95827-2539
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Country | US
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Telephone | 800-470-0071
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Fax |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E2600
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License Number State | CA
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