Provider Demographics
NPI:1265252035
Name:LOCKE, JAMES ALLEN
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:LOCKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 S ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:STOCKPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43787-9314
Mailing Address - Country:US
Mailing Address - Phone:740-509-6104
Mailing Address - Fax:
Practice Address - Street 1:2380 S ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:STOCKPORT
Practice Address - State:OH
Practice Address - Zip Code:43787-9314
Practice Address - Country:US
Practice Address - Phone:740-509-6104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide