Individual
MR. MICHAEL ORLAN LOCKHART JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5860
(580) 379-5859
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5860
(580) 379-5859
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
116396
OK
367500000X
Certified Registered Nurse Anesthetist
RN071814AP02740
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1674796
—
LA
05
—
200580280A
—
OK
Enumeration date
02/12/2007
Last updated
08/29/2022
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