Jason L Lockridge, M.D.
Dermatology in Palm Bay, FL. Individual provider (NPI-1).
NPI number1922092576
StatusActive
Last updated in NPPESMay 17, 2022
Details
- NPI
- 1922092576
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jason L Lockridge
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 8, 2005
- Certification date
- May 17, 2022
- Last updated
- May 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | ME140072 | FL | Yes |
Practice location
1761 Palm Bay Rd NePalm Bay, FL 32905-2902
Phone 321-220-6400 · Fax 321-220-6401
Mailing address
900 Village Square Xing Ste 290Palm Beach Gardens, FL 33410-4552
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