Provider Demographics
NPI:1285213710
Name:LOCKETT, ELIZABETH HALE (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HALE
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 UNIVERSITY HOSPITAL DR.
Mailing Address - Street 2:MASTIN BUILDING, ROOM 719
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617
Mailing Address - Country:US
Mailing Address - Phone:251-445-8282
Mailing Address - Fax:
Practice Address - Street 1:2451 UNIVERSITY HOSPITAL DR.
Practice Address - Street 2:MASTIN BUILDING, ROOM 719
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617
Practice Address - Country:US
Practice Address - Phone:251-445-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.45373208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program