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Individual
DEBORAH LOCKWOOD
Active
Individual
DEBORAH LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
117957
MO
363A00000X
Physician Assistant
Primary
15-01030
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200334360A
—
KS
01
—
481159444
JAYHAWK TAX ID
—
01
—
928367
FIRSTGUARD
—
Enumeration date
06/02/2006
Last updated
11/20/2009
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