Provider Demographics
NPI:1942289103
Name:RICHARD H LOCKWOOD M.D. P.C.
Entity Type:Organization
Organization Name:RICHARD H LOCKWOOD M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-492-5794
Mailing Address - Street 1:BROAD RD
Mailing Address - Street 2:COMMUNITY HOSPITAL POB SUITE 2S
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-5100
Mailing Address - Country:US
Mailing Address - Phone:315-492-5794
Mailing Address - Fax:
Practice Address - Street 1:BROAD RD
Practice Address - Street 2:COMMUNITY HOSPITAL POB SUITE 2S
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-5100
Practice Address - Country:US
Practice Address - Phone:315-492-5794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty