Provider Demographics
NPI:1043351240
Name:LOCKHART, LARRY EARL (RP)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:EARL
Last Name:LOCKHART
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 NORTHFORK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3577
Mailing Address - Country:US
Mailing Address - Phone:402-421-8141
Mailing Address - Fax:
Practice Address - Street 1:15TH AND U ST
Practice Address - Street 2:UNIVERSITY HEALTH CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-0618
Practice Address - Country:US
Practice Address - Phone:402-472-7457
Practice Address - Fax:402-472-7401
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist