Provider Demographics
NPI:1376535930
Name:CURTIS LOCKHART, M.D., INC.
Entity Type:Organization
Organization Name:CURTIS LOCKHART, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:MAJOR
Authorized Official - Last Name:LOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-892-5794
Mailing Address - Street 1:29101 HEALTH CAMPUS DR
Mailing Address - Street 2:BUILDING 2 - SUITE 155
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5270
Mailing Address - Country:US
Mailing Address - Phone:440-892-5794
Mailing Address - Fax:440-892-5798
Practice Address - Street 1:29101 HEALTH CAMPUS DR
Practice Address - Street 2:BUILDING 2 - SUITE 155
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5270
Practice Address - Country:US
Practice Address - Phone:440-892-5794
Practice Address - Fax:440-892-5798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2272820Medicaid
OH2272820Medicaid
OH=========-01OtherBWC GROUP#
OHCU9310971Medicare ID - Type UnspecifiedGROUP MEDICARE #