Provider Demographics
NPI:1982797411
Name:LOCKETTE, KEVIN F (RPT)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:F
Last Name:LOCKETTE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481-C KAWAILOA ROAD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734
Mailing Address - Country:US
Mailing Address - Phone:808-261-1514
Mailing Address - Fax:
Practice Address - Street 1:1314 SOUTH KING STREET
Practice Address - Street 2:SUITE 1451
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-593-2610
Practice Address - Fax:808-591-9420
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0137318OtherUHA 99033202001
HI193484OtherHMA
HI49355200OtherALOHA CARE
HIF0226446OtherTRICARE KAI
HIA22644-7OtherHNL HMSA PPO/HMO/QST/65C
HI49355204Medicaid
HIA22644-7OtherTRICARE HNL
HI49355201Medicaid
HIF0226446OtherKAI HMSA PPO/HMO/QST/65C
HI49355201Medicaid