Individual
DARRELL R LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24900 SE STARK ST, STE 109, GRESHAM INTERNAL MEDICINE CLINIC, GRESHAM, OR 97030
(503) 667-1015
(503) 667-0406
Mailing address
PO BOX 23200, PORTLAND, OR 97281-3200
(503) 667-1015
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD08631
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231548
—
OR
Enumeration date
01/06/2006
Last updated
12/19/2007
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