Organization
NORTHEAST KINGDOM HEMATOLOGY ONCOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE C LOCKRIDGE MD (SOLE PROPRIETOR/SOLE OWNER)
(802) 334-7177
Entity
Organization
Contact information
Practice address
637 UNION ST, NEWPORT, VT 05855-5498
(802) 334-7177
(802) 487-9299
Mailing address
PO BOX 838, 637 UNION STREET, NEWPORT, VT 05855-5498
(802) 334-7177
(802) 487-9299
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0420011226
VT
Other
Enumeration date
04/24/2014
Last updated
10/28/2014
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