Individual
MARK A LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
17930
SC
208600000X
Surgery Physician
MD35383
TN
2086X0206X
Surgical Oncology Physician
Primary
17930
SC
Other
Enumeration date
09/16/2005
Last updated
08/16/2013
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