Individual
DR. JEFFERY CLYDE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
(321) 725-4755
(321) 725-5088
Mailing address
2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
(321) 725-4755
(321) 725-5088
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP000891
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32800
BCBS
FL
01
—
38200A
BCBS
FL
Enumeration date
01/23/2006
Last updated
02/14/2008
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