| Michael Lock, Ph.d. | |
|
4815 S Harvard Ave Suite 250 Tulsa OK 74135-3060 | |
| (918) 804-7561 | |
| (918) 392-4845 |
| Full Name | Michael Lock, Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 4815 S Harvard Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Michael L Lock (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9188047561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Lock, Ph.d. 4815 S Harvard Ave Suite 250 Tulsa OK 74135-3060 Ph: (918) 804-7561 | Michael Lock, Ph.d. 4815 S Harvard Ave Suite 250 Tulsa OK 74135-3060 Ph: (918) 804-7561 |
| NPI Number | 1053650903 |
|---|---|
| Provider Enumeration Date | 02/12/2013 |
| Last Update Date | 01/16/2014 |
| Medicare PECOS PAC ID | 4486977485 |
|---|---|
| Medicare Enrollment ID | O20141224000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053650903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 611 (Oklahoma) | Primary |
| Provider Name | Michael L Lock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396858932 PECOS PAC ID: 8527163476 Enrollment ID: I20070420000413 |
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