Individual provider · Type 1 NPI

Clyde Milton Lockett Jr.

Contractor · South Bend, IN

NPI number 1174291520 Active

Practice location

1251 N Eddy St Ste 200
South Bend, IN 46617-1478

Call (219) 312-1020 Map

Mailing address

PO Box 312
Crown Point, IN 46308-0312

Specialties and licenses

TaxonomyCodeLicense
Driver 172A00000XNone listed
Contractor Primary 171W00000XNone listed

Contractor: For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no re…

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About NPI 1174291520

Clyde Milton Lockett Jr.'s National Provider Identifier is 1174291520, issued on Sep 1, 2021. The primary taxonomy on file is Contractor (171W00000X), and the practice location is in South Bend, IN. The record was last updated on Sep 1, 2021.