Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 43767 | TN |
N | 208000000X | Pediatrician | 27981 | SC |
Y | 2080P0204X | Pediatric Emergency Doctor | 43767 | TN |
NPI | 1457484727 |
---|---|
Provider Name | Matthew Ryan Locklair |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 12/09/2012 |