Individual
JIMMY WAYNE LOCKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 37TH STREET, VERO BEACH, FL 32960
(772) 778-2106
(772) 562-5739
Mailing address
1600 37TH ST, VERO BEACH, FL 32960-4863
(727) 376-6578
(727) 376-6784
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME90530
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270890600
—
FL
Enumeration date
09/07/2006
Last updated
09/19/2017
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