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1750378758

NPI Code Detail

MEDICARE: CYNTHIA LOCKERD DO

MEDICARE: CYNTHIA LOCKERD 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	207Q00000X	Family Medicine Physician	5101011388	MI
2	207Q00000X	Family Medicine Physician	35741	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	120002169	OTHER		PALMETTO GBA RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA2081015126	OTHER		PREFERRED ONE
2	700B960280	OTHER	MI	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0115319	OTHER		MEDICA
5	111661	OTHER		UCARE MINNESOTA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	1063376	OTHER	MI	MCLAREN HEALTH PLAN
8	2M018LO	OTHER	MN	BCBS MINNESOTA
10	21394	OTHER		SIOUX VALLEY HEALTH PLAN

General Provider Information

NPI Number	:	1750378758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA LOCKERD DO

Provider Business Mailing Address
First Line	:	803 4TH ST
Second Line	:
City	:	JACKSON
State	:	MN
Zip	:	56143-1056
Country	:	US
Telephone Number	:	507-847-3571
Fax Number	:	507-847-5664

Provider Business Practice Location Address
First Line	:	1717 N HIGH ST
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48906-4529
Country	:	US
Telephone Number	:	517-371-1700
Fax Number	:	517-371-4245

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/17/2021

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Directions to “ CYNTHIA LOCKERD DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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