Individual
DR. JUSTIN LAWRENCE LOCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
MD442301
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD442301
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025929790001
—
PA
01
—
221556EMD
MEDICARE PTAN
PA
Enumeration date
02/01/2007
Last updated
12/28/2022
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