Provider Demographics
NPI:1689937054
Name:LOCKHART, JAMES P (MEDICAL DOCTOR)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:P
Last Name:LOCKHART
Suffix:
Gender:M
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 MONTGOMERY COR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1431
Mailing Address - Country:US
Mailing Address - Phone:408-440-4937
Mailing Address - Fax:408-440-4925
Practice Address - Street 1:6006 MONTGOMERY COR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-1431
Practice Address - Country:US
Practice Address - Phone:408-440-4937
Practice Address - Fax:408-440-4925
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC24774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine