MEDICARE: MOLLY E WATKINS RDMS (OB)

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
1	2085U0001X	Diagnostic Ultrasound Physician	122499	ID

General Provider Information

NPI Number	:	1427876457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY E WATKINS RDMS (OB)

Provider Business Mailing Address
First Line	:	2073 MAPLE AVE
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-6774
Country	:	US
Telephone Number	:	208-731-4168
Fax Number	:

Provider Business Practice Location Address
First Line	:	2073 MAPLE AVE
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-6774
Country	:	US
Telephone Number	:	208-731-4168
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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