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General NPI Number Information
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NPI Number | 1962416354
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Entity Type | Individual
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Provider Name | DALE CHRISTOPHER LOCKHART OD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5201 RAYMOND ST
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City | ORLANDO
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State | FL
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Zip | 32803
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Country | US
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Telephone | 407-629-1599
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Fax | 407-599-1340
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Provider Business Mailing Address
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Address Line | 14190 DELJEAN CIRCLE
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City | ORLANDO
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State | FL
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Zip | 32828-8005
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Country | US
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Telephone | 407-629-1599
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Fax | 407-599-1340
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OE005135T
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License Number State | PA
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