Individual
DEBORAH LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7405 RENNER RD, KU MEDWEST, SHAWNEE, KS 66217-9414
(913) 588-8400
(913) 588-8413
Mailing address
2330 SHAWNEE MISSION PKWY, MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312, WESTWOOD, KS 66205-2005
(913) 588-9000
(913) 588-9822
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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