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1326191669 NPI number — CHRISTOPHER E LOCKETTE P.A.-C

NPI Number: 1326191669
Health Care Provider/Practitioner: CHRISTOPHER E LOCKETTE P.A.-C

Information about “1326191669” NPI (CHRISTOPHER E LOCKETTE P.A.-C) exists in 1326191669 in HTML format HTML  |  1326191669 in plain Text format TXT  |  1326191669 in PDF (Portable Document Format) PDF  |  1326191669 in an XML format XML  formats.

NPI Number : 1326191669 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326191669",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LOCKETTE",
    "FirstName": "CHRISTOPHER",
    "MiddleName": "E",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "P.A.-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6525 HUGH WILLIS RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "POWELL",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37849-5617",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "865-724-7836",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "189 BROOKLAWN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KNOXVILLE",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37934-2875",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "865-392-9136",
    "PracticeLocationAddressFaxNumber": "865-392-9137",
    "EnumerationDate": "01/19/2007",
    "LastUpdateDate": "10/20/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "1505",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA9103430",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA3654",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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