Basic Information
Provider Information
NPI: 1073582086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOCKWOOD
FirstName: DEBORAH
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1122 NE 13TH ST
Address2: ORI 236
City: OKLAHOMA CITY
State: OK
PostalCode: 731171039
CountryCode: US
TelephoneNumber: 4052711515
FaxNumber:  
Practice Location
Address1: 825 NE 10TH ST
Address2: OUPB 2500
City: OKLAHOMA CITY
State: OK
PostalCode: 731045417
CountryCode: US
TelephoneNumber: 4052717001
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/14/2006
LastUpdateDate: 03/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X22792OKN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0001X22792OKY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

No ID Information.


Home