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Individual

MR. IVAN RAFAEL LOCKWARD JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
20 S BLACK HORSE PIKE, RUNNEMEDE, NJ 08078-1901
(856) 962-8840
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935
(732) 790-0107

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA12662800
NJ
207R00000X
Internal Medicine Physician
33783R
PR

Other

Enumeration date
08/23/2018
Last updated
06/03/2025
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