Individual
DR. KENNETH EDWARD LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1002C E 4TH AVE, RED SPRINGS, NC 28377-1642
(910) 843-3311
(910) 843-3599
Mailing address
1002C E 4TH AVE, RED SPRINGS, NC 28377-1642
(910) 843-3311
(910) 843-3599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
000024605
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8952453
—
NC
01
—
TAX ONOMY NUMBER
TAX ONOMY NUMBER
NC
Enumeration date
07/01/2005
Last updated
03/11/2010
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