Provider Demographics
NPI:1700123767
Name:LOCKETT, LETITIA OKORLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LETITIA
Middle Name:OKORLEY
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7272 GADSDEN HWY
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1687
Mailing Address - Country:US
Mailing Address - Phone:205-661-3506
Mailing Address - Fax:205-661-3272
Practice Address - Street 1:7272 GADSDEN HWY
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1687
Practice Address - Country:US
Practice Address - Phone:205-661-3506
Practice Address - Fax:205-661-3272
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist