Individual
MICHAEL LOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
247 S MAIN ST, REIDSVILLE, GA 30453-4605
(912) 557-1000
Mailing address
PO BOX 784, VIDALIA, GA 30475-0784
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN235719
GA
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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