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Individual

DR. TAKEIA J. LOCKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
1270 CAROLINE ST NE, SUITE D120-377, ATLANTA, GA 30307-2758
(202) 320-7373
(678) 298-9903
Mailing address
1270 CAROLINE ST NE, SUITE D120-377, ATLANTA, GA 30307-2758
(202) 320-7373
(678) 298-9903

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC4271
FL
152W00000X
Optometrist
OPT002490
GA
152WP0200X
Pediatric Optometrist
Primary
OPT002490
GA
152WS0006X
Sports Vision Optometrist
OPT002490
GA
152WV0400X
Vision Therapy Optometrist
OPT002490
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
520474424A
GA
05
520474424B
GA
Enumeration date
09/07/2007
Last updated
11/13/2009
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