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Contact Information

CLYDE M LOCKETT JR
1251 N EDDY ST STE 200
SOUTH BEND, IN46617-1478
 Phone: 219-312-1020
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Contractor

171W00000X
 

Driver

172A00000X
Indicates primary specialty

NPI Profile & details for CLYDE M LOCKETT JR · (Male)

NPI # 1174291520
Status Active
Credentials
Entity Individual
Enumeration date 09/01/2021
Last updated 09/01/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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