Provider Demographics
NPI:1669680310
Name:LOCKHART, STACI MICHELE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACI
Middle Name:MICHELE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 CHERRY LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6860
Mailing Address - Country:US
Mailing Address - Phone:405-701-3522
Mailing Address - Fax:
Practice Address - Street 1:1110 N STONEWALL AVE
Practice Address - Street 2:CPB RM 244
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1200
Practice Address - Country:US
Practice Address - Phone:405-271-6878
Practice Address - Fax:405-271-6430
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK120491835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy