Individual
DR. JASON KENT LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(800) 475-6236
(706) 653-1162
Mailing address
PO BOX 678207, DALLAS, TX 75267-8207
(800) 841-4236
(706) 653-1162
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
36008
SC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
36008
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2013
Last updated
05/17/2019
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