Provider Demographics
NPI:1881276806
Name:LOCKARD, ROY L JR (PSS)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:L
Last Name:LOCKARD
Suffix:JR
Gender:M
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 FULDNER RD
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-7328
Mailing Address - Country:US
Mailing Address - Phone:803-541-1245
Mailing Address - Fax:803-541-1247
Practice Address - Street 1:179 FULDNER RD
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-7328
Practice Address - Country:US
Practice Address - Phone:803-541-1245
Practice Address - Fax:803-541-1247
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist