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Organization
AEGIS MEDICAL SOLUTIONS 1 LLC
Active
Organization
AEGIS MEDICAL SOLUTIONS 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY P LOCKETT D.O. (MEDICAL DIRECTOR)
(727) 443-4242
Entity
Organization
Contact information
Practice address
1012 DRUID RD E, CLEARWATER, FL 33756-5606
(727) 443-4242
(727) 441-1158
Mailing address
1012 DRUID RD E, CLEARWATER, FL 33756-5606
(727) 443-4242
(727) 441-1158
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS6109
LICENSE NUMBR
FL
Enumeration date
02/19/2019
Last updated
02/19/2019
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