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NPI Code Detail

MEDICARE: DAVID P WATKINS M.D.

MEDICARE: DAVID P WATKINS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician01038603IN
2207Q00000XFamily Medicine Physician01038603IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000697398OTHERINANTHEM
2000000088993OTHERINANTHEM ID FOR FAMILY PRAC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000226063OTHERINANTHEM ID FOR ANESTHESIA

General Provider Information

NPI Number : 1265422919
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID P WATKINS M.D.
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 306 E MAUMEE ST STE 201
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2035
Country : US
Telephone Number : 260-667-2700
Fax Number : 260-667-2611
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 11/15/2022

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Directions to “ DAVID P WATKINS M.D.” Practice Location

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