Individual
PATRINA LOCKETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
354 E. WASHINGTON AVE., ASHBURN, GA 31714-5222
(229) 567-3361
(229) 567-4083
Mailing address
807 S. ISABELLA ST., PO BOX 545, SYLVESTER, GA 31791-0545
(229) 777-4514
(229) 776-7062
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048855
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000876686F
—
GA
05
—
000876686G
—
GA
Enumeration date
07/09/2006
Last updated
06/17/2011
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