Individual
DR. FREDERICKA CREECH LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
107 PERRY ST, BLOOMFIELD, KY 40008
(502) 252-5081
(502) 252-7211
Mailing address
PO BOX 400, BLOOMFIELD, KY 40008
(502) 252-5081
(502) 252-7211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19893
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047086
ANTHEM
—
01
—
080025519
RAILROAD MEDICARE
—
01
—
1049285
PASSPORT
—
01
—
243244900
PASSPORT
—
01
—
610963741B
HUMANA
—
05
—
64198930
—
KY
Enumeration date
05/10/2006
Last updated
05/07/2012
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