MEDICARE: DR. RICKY P. LOCKETT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	OS6109	FL
2	207Q00000X	Family Medicine Physician	OS6109	FL
3	174400000X	Specialist	59-3207217	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	80494	OTHER	FL	BC/BS PROVIDER ID
3	OS 6109	OTHER	FL	LICENSE NUMBER

General Provider Information

NPI Number	:	1356410443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICKY P. LOCKETT DO

Provider Business Mailing Address
First Line	:	PO BOX 2788
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33780-2788
Country	:	US
Telephone Number	:	727-896-8686
Fax Number	:	727-317-2716

Provider Business Practice Location Address
First Line	:	5800 49TH ST N STE S-207
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33709-2146
Country	:	US
Telephone Number	:	727-896-8686
Fax Number	:	727-317-2716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	12/02/2025

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Directions to “ DR. RICKY P. LOCKETT DO” Practice Location

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