Individual
DR. TAKEIA J. LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
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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