Doctor Name: | MISS MARY KAY LOCKWOOD |
NPI Number: | 1356377592 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ATC L |
License Number: | AL1939 |
Business Practice Address: | 1800 Barrs St St Vincents Medical Center Jacksonville, FL - 32204 |
Business Phone Number: | 9043087741 |
Business Fax Number: | |
Mailing Address: | 126 Tortuga Lane, PONTE VEDRA BEACH |
State: | FL |
Postal Code: | 32082 |
Phone Number: | 9042549663 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225500000X |
License Number: | AL1939 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |