MEDICARE: DR. ANNE S LOCKEY M.D.

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	2084P0800X	Psychiatry Physician	ME19661	FL

General Provider Information

NPI Number	:	1861765406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE S LOCKEY M.D.

Provider Business Mailing Address
First Line	:	4311 POINT CT
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-9499
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4311 POINT CT
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-9499
Country	:	US
Telephone Number	:	941-625-7094
Fax Number	:

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

Provider Enumeration Date	:	02/13/2012
Last Update Date	:	02/13/2012

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