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Individual
MARK D LOCKETT
Active
Individual
MARK D LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
30405
AZ
207Q00000X
Family Medicine Physician
30405
AZ
207Q00000X
Family Medicine Physician
MD2010-0156
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
733958
—
AZ
Enumeration date
09/21/2005
Last updated
02/10/2022
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