Individual
STACEY W LOCKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5230 E STOP 11 RD STE 250, INDIANAPOLIS, IN 46237-6399
(317) 528-8921
(317) 528-6916
Mailing address
PO BOX 781008, DETROIT, MI 48278-1008
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01078257A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2015
Last updated
08/29/2022
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