Provider Demographics
NPI:1922088871
Name:LOCKWOOD, RICHARD HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HOWARD
Last Name:LOCKWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 GADWALL LN
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-9395
Mailing Address - Country:US
Mailing Address - Phone:315-569-0051
Mailing Address - Fax:
Practice Address - Street 1:4600 SOUTHWOOD HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9595
Practice Address - Country:US
Practice Address - Phone:315-469-1300
Practice Address - Fax:315-469-5545
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B82168Medicare UPIN