Provider Demographics
NPI:1982199576
Name:LOCKHART, MILAN CHRISTOPHER (OD - OPTOMETRIST)
Entity Type:Individual
Prefix:MR
First Name:MILAN
Middle Name:CHRISTOPHER
Last Name:LOCKHART
Suffix:
Gender:M
Credentials:OD - OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HAYWOOD RD, BOX 227
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-234-5350
Mailing Address - Fax:864-234-5352
Practice Address - Street 1:700 HAYWOOD RD
Practice Address - Street 2:STE 2018E
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-234-5350
Practice Address - Fax:864-234-5352
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2074152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist