MEDICARE: DR. SCOTT A LOCKWOOD MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	3564	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2F818LO	OTHER	MN	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0002152	OTHER	SD	BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508806704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT A LOCKWOOD MD

Provider Business Mailing Address
First Line	:	2871 E OLD ORCHARD TRL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-4369
Country	:	US
Telephone Number	:	605-334-2454
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 S CLIFF AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57105-1005
Country	:	US
Telephone Number	:	605-322-7246
Fax Number	:	605-322-2891

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	04/12/2018

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Directions to “ DR. SCOTT A LOCKWOOD MD” Practice Location

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