Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 035287 | GA |
NPI | 1265425912 |
---|---|
Provider Name | Dr. Rick Lockhart |
First Address | Milledgeville, GA 31061-7106 |
Second Address | Milledgeville, GA 31061-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2005 |
Last Update Date | 09/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00494755A | (05) | GA |
F24433 | (02) | GA |