MEDICARE: BRYCE DAVID LOKEY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	20A19103	CA

General Provider Information

NPI Number	:	1225298177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYCE DAVID LOKEY DO

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:	540-224-5352
Fax Number	:

Provider Business Practice Location Address
First Line	:	34800 BOB WILSON DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-1838
Country	:	US
Telephone Number	:	619-532-9399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	05/20/2024

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