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Individual

CHARLES J LOCKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 TAMPA GENERAL CIR, STC 4TH FLOOR, TAMPA, FL 33606-3603
(813) 259-8500
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
026259
CT
207VM0101X
Maternal & Fetal Medicine Physician
35098779
OH
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME120422
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013106700
FL
01
14V4B
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/22/2005
Last updated
10/19/2020
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