Provider Demographics
NPI:1902992233
Name:LOCKWOOD, JULIA D (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:D
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04078
Mailing Address - Country:US
Mailing Address - Phone:207-865-9268
Mailing Address - Fax:
Practice Address - Street 1:45 FOREST FALLS DRIVE
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096
Practice Address - Country:US
Practice Address - Phone:207-846-9761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0110802080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine