Provider Demographics
NPI:1205834207
Name:LOCAY, HAROLD R (MD, PA)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:R
Last Name:LOCAY
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 SE 3RD CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0421
Mailing Address - Country:US
Mailing Address - Phone:352-622-4231
Mailing Address - Fax:352-622-0513
Practice Address - Street 1:6520 NW 9TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4205
Practice Address - Country:US
Practice Address - Phone:352-331-7987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2022-07-21
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
FLME61963207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110091315OtherRRMC (GRP)
FL373134100Medicaid
FLCD4677OtherRRMC/GROUP
FLF63780Medicare UPIN
FL23061Medicare PIN