1750382727 NPI number — JOEL R LOCKE MD

Table of content: JOEL R LOCKE MD (NPI 1750382727)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750382727 NPI number — JOEL R LOCKE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOCKE
Provider First Name:
JOEL
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750382727
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 409879
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-9879
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-261-6000
Provider Business Mailing Address Fax Number:
615-261-6052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4601 CAROTHERS PKWY
Provider Second Line Business Practice Location Address:
SUITE 475
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-790-1660
Provider Business Practice Location Address Fax Number:
615-790-3705
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  MD13433 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: 13433 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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