Provider Demographics
NPI:1326191669
Name:LOCKETTE, CHRISTOPHER E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:E
Last Name:LOCKETTE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 HUGH WILLIS RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5617
Mailing Address - Country:US
Mailing Address - Phone:865-724-7836
Mailing Address - Fax:
Practice Address - Street 1:189 BROOKLAWN ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2875
Practice Address - Country:US
Practice Address - Phone:865-392-9136
Practice Address - Fax:865-392-9137
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1505363A00000X
FLPA9103430363A00000X
COPA3654363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant