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Organization
KEVIN G. LOCKHART, O.D., INC
Active
Organization
KEVIN G. LOCKHART, O.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI LEE LOCKHART (OFFICE MANAGER)
(916) 791-5490
Entity
Organization
Contact information
Practice address
5520 DOUGLAS BLVD, SUITE 110, GRANITE BAY, CA 95746-6288
(916) 791-5490
(916) 791-3099
Mailing address
5520 DOUGLAS BLVD, SUITE 110, GRANITE BAY, CA 95746-6288
(916) 791-5490
(916) 791-3099
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9297T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2230825
—
CA
Enumeration date
08/12/2008
Last updated
04/23/2013
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