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General NPI Number Information
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NPI Number | 1558925248
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Entity Type | Individual
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Provider Name | CHRISTINA JOAN LOCKE OD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2019
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 5995 BARFIELD RD
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-4411
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Country | US
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Telephone | 404-256-1507
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Fax | 404-256-1981
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Provider Business Mailing Address
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Address Line | 5901 PEACHTREE DUNWOODY RD STE A500
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City | ATLANTA
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State | GA
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Zip | 30328-7162
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Country | US
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Telephone | 678-781-7373
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Fax | 678-538-1972
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 006754
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003235
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License Number State | GA
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