Lockhart, Kelley Rae
Lockhart, Kelley Rae is an individual health care provider with primary practice located at 11104 Parkview Circle Dr Ste 110 , Fort Wayne IN 46845-1673. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is her primary health care specialty. Lockhart, Kelley Rae can be contacted via phone (260) 425-6780.Contact Information
Primary practice address
11104 Parkview Circle Dr Ste 110
Fort Wayne IN 46845-1673
Phone: (260) 425-6780
Fax: (260) 425-6789
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | DR.0054479 | Colorado |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 47972 | Minnesota |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 01082503A | Indiana |
Profile Details
| NPI number | 1033192679 |
|---|---|
| LBN Legal business name | Lockhart, Kelley Rae |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2005 |
| Last updated | Jan 17th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033192679 | NPPES |
| Minnesota | MEDICAID | 956422500 |
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