Doctor Name: | MRS. VALENCIA WILSON LOCKHART |
NPI Number: | 1235215328 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA175 |
Business Practice Address: | 7950 Martin Loop Fort Benning, GA - 319055647 |
Business Phone Number: | 7065441123 |
Business Fax Number: | |
Mailing Address: | 239 Lee Road 665, AUBURN |
State: | AL |
Postal Code: | 368328805 |
Phone Number: | 3348214421 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA175 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |