Individual
DR. GREGORY R LOCKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 444-4000
(401) 427-7795
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
MD08011
RI
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD08011
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04/15/2009
UNITED HEALTHCARE
RI
01
—
1/11/2007
NHPRI
RI
01
—
1003855339
NPI
RI
01
—
12/29/2008
TUFTS HEALTH PLAN
MA
01
—
3184757
MA MEDICAID
RI
01
—
410745
BLUECHIP
—
05
—
7003619
—
RI
01
—
939025129
RI MEDICARE GROUP NUMBER
RI
Enumeration date
06/05/2006
Last updated
08/22/2018
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