Individual
ASHLEY MARIE LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1709 BERWICK DR, SUITE B, LAURINBURG, NC 28352-5547
(910) 521-2900
(910) 775-9165
Mailing address
60 COMMERCE PLZ, PEMBROKE, NC 28372-7386
(910) 521-2900
(910) 775-9165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02525
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-02525
NORTH CAROLINA MEDICAL BOARD
NC
01
—
163UV
BCBSNC
NC
01
—
1861700809
COVENTRY/WELLPATH
NC
05
—
8101348
—
NC
01
—
P01128154
RAILROAD MEDICARE
NC
Enumeration date
09/23/2010
Last updated
11/25/2013
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