Healthcare Provider Details

I. General information

NPI: 1174057343
Provider Name (Legal Business Name): JOHN W LOCKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 22ND AVE N
NASHVILLE TN
37203-1802
US

IV. Provider business mailing address

222 22ND AVE N
NASHVILLE TN
37203-1802
US

V. Phone/Fax

Practice location:
  • Phone: 629-255-2062
  • Fax: 629-255-4078
Mailing address:
  • Phone: 629-255-3486
  • Fax: 629-255-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number76670
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: