Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | MD08011 | RI |
Y | 2080P0204X | Pediatric Emergency Doctor | MD08011 | RI |
NPI | 1003855339 |
---|---|
Provider Name | Dr. Gregory R Lockhart |
First Address | Providence, RI 02940-9484 |
Second Address | Providence, RI 02903-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 22/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04/15/2009 | UNITED HEALTHCARE (01) | RI |
1/11/2007 | NHPRI (01) | RI |
1003855339 | NPI (01) | RI |
12/29/2008 | TUFTS HEALTH PLAN (01) | MA |
3184757 | MA MEDICAID (01) | RI |
410745 | BLUECHIP (01) | |
7003619 | (05) | RI |
939025129 | RI MEDICARE GROUP NUMBER (01) | RI |
F70878 | (02) | RI |