Doctor Name: | JOSEPH A LOCKE |
NPI Number: | 1902078801 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O |
License Number: | 53594-21 |
Business Practice Address: | W176n9830 Rivercrest Dr Suite 102 Germantown, WI - 530224625 |
Business Phone Number: | 4143240944 |
Business Fax Number: | 4149215600 |
Mailing Address: | W176n9830 Rivercrest Dr, Suite 102 GERMANTOWN |
State: | WI |
Postal Code: | 530224625 |
Phone Number: | 4143240944 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2008 |
NPI Last Update Date: | 03/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 53594-21 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |