Basic Information
| Provider Information | |||||||||
| NPI: | 1033789920 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOCKABY | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | ROY | ||||||||
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| NameSuffix: | JR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2366 NEW MARKET RD | ||||||||
| Address2: | |||||||||
| City: | SARDINIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451719404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135357490 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 MALLARD COVE DR | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452463941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138305014 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2021 | ||||||||
| LastUpdateDate: | 07/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 012970 | OH | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.