Individual
DR. JUSTIN RYAN LOCKREM
Active
Individual
DR. JUSTIN RYAN LOCKREM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01091015A
IN
207RS0010X
Sports Medicine (Internal Medicine) Physician
01091015A
IN
208000000X
Pediatrics Physician
01091015A
IN
Other
Enumeration date
05/22/2015
Last updated
09/26/2023
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