Individual
DR. JASON LYNN LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
812 CANDY PARK RD, SUITE 6103, PEMBROKE, NC 28372-9129
(910) 521-3093
(910) 521-3095
Mailing address
PO BOX 2219, PEMBROKE, NC 28372-2219
(910) 521-3093
(910) 521-3095
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2959
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085CG
BLUE CROSS BLUE SHEILD
NC
01
—
350055135
RAILROAD MEDICARE
NC
05
—
89085CG
—
NC
Enumeration date
05/04/2006
Last updated
05/20/2013
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