1649269416 NPI number — DR. STEPHEN DANIEL LOCKEY III MD

Table of content: DR. STEPHEN DANIEL LOCKEY III MD (NPI 1649269416)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649269416 NPI number — DR. STEPHEN DANIEL LOCKEY III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOCKEY
Provider First Name:
STEPHEN
Provider Middle Name:
DANIEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649269416
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2445 MARIETTA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17601-1942
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-393-1365
Provider Business Mailing Address Fax Number:
717-393-8540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2445 MARIETTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-1942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-393-1365
Provider Business Practice Location Address Fax Number:
717-393-8540
Provider Enumeration Date:
10/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  MD011652E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0038793000 . This is a "AMERICHEALTH HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0038793000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0052371 . This is a "HIGHMARK BLUE SHIELD PA B" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1649269416 . This is a "NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0052371 . This is a "KEYSTONE HEALTH PLAN CENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01459101 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30108B . This is a "AMERIHEALTH MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0006752560001 . This is a "ACCESS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0466425 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 248731 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 29406 . This is a "GEISINGER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 116337 . This is a "UNISON (MEDPLUS)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 729832001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030003465 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 116337 . This is a "THREE RIVERS MEDPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1519956 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000675256 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0052371 . This is a "BLUE CROSS AND BLUE SHIEL" identifier . This identifiers is of the category "OTHER".