Provider Demographics
NPI:1376395582
Name:LOCKWOOD, MORGAN ALANNA (DO)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ALANNA
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22250 PROVIDENCE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6213
Mailing Address - Country:US
Mailing Address - Phone:248-849-3441
Mailing Address - Fax:248-849-4132
Practice Address - Street 1:22250 PROVIDENCE DR STE 500
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6213
Practice Address - Country:US
Practice Address - Phone:248-849-3441
Practice Address - Fax:248-849-4132
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program