Provider Demographics
NPI:1649269416
Name:LOCKEY, STEPHEN DANIEL III (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DANIEL
Last Name:LOCKEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2445 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1942
Mailing Address - Country:US
Mailing Address - Phone:717-393-1365
Mailing Address - Fax:717-393-8540
Practice Address - Street 1:2445 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1942
Practice Address - Country:US
Practice Address - Phone:717-393-1365
Practice Address - Fax:717-393-8540
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011652E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0038793000OtherAMERICHEALTH HMO
0038793000OtherKEYSTONE HEALTH PLAN EAST
0052371OtherHIGHMARK BLUE SHIELD PA B
PA1649269416OtherNPI
0052371OtherKEYSTONE HEALTH PLAN CENT
01459101OtherCAPITAL BLUE CROSS
30108BOtherAMERIHEALTH MERCY
PA0006752560001OtherACCESS
0466425OtherAETNA
248731OtherMAMSI
29406OtherGEISINGER
PA116337OtherUNISON (MEDPLUS)
729832001OtherCIGNA
030003465OtherRAILROAD MEDICARE
116337OtherTHREE RIVERS MEDPLUS
1519956OtherGATEWAY
PA000675256Medicaid
0052371OtherBLUE CROSS AND BLUE SHIEL
C28486Medicare UPIN
PA000675256Medicaid