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Individual

MATTHEW RYAN LOCKLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
DEPT OF EMERGENCY MEDICINE VANDERBILT, MEDICAL CENTER 703 OXFORD HOUSE,1313 21ST AVE SOUTH, NASHVILLE, TN 37232-0001
(615) 936-3898
(615) 322-4374
Mailing address
DEPT OF EMERGENCY MEDICINE VANDERBILT, MEDICAL CENTER 703 OXFORD HOUSE,1313 21ST AVE SOUTH, NASHVILLE, TN 37232-0001
(615) 936-3898
(615) 322-4374

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
43767
TN
208000000X
Pediatrics Physician
27981
SC
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
43767
TN
390200000X
Student in an Organized Health Care Education/Training Program
43767
TN

Other

Enumeration date
03/14/2007
Last updated
09/12/2012
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