Provider Demographics
NPI:1003146283
Name:SAWYER, BECKY LOCKHART (PA-C)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:LOCKHART
Last Name:SAWYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LOCKHART
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:THE ORTHOPAEDIC CLINIC P.C.
Mailing Address - Street 2:121 NORTH 20TH ST. # 18
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801
Mailing Address - Country:US
Mailing Address - Phone:334-749-8303
Mailing Address - Fax:334-745-5243
Practice Address - Street 1:121 N 20TH ST STE 18
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5457
Practice Address - Country:US
Practice Address - Phone:334-749-8303
Practice Address - Fax:334-745-5243
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1496363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L24105Medicare PIN