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General NPI Number Information
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NPI Number | 1396408977
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Entity Type | Individual
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Provider Name | CONNOR A LOCKRIDGE
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Gender | Male
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 5665 PEACHTREE DUNWOODY RD
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City | ATLANTA
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State | GA
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Zip | 30342-1764
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Country | US
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Telephone | 470-371-9422
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 JEFFERSON CIR S
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City | CHAMBLEE
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State | GA
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Zip | 30341-2639
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Country | US
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Telephone | 770-757-3156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 033061
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License Number State | GA
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