Individual
KEYA AISHA LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
653 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-4390
Mailing address
302 E 2ND ST, JACKSONVILLE, FL 32206-5110
(607) 621-6730
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301110844
MI
207L00000X
Anesthesiology Physician
ME129171
FL
Other
Enumeration date
04/26/2012
Last updated
08/02/2017
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