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General NPI Number Information
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NPI Number | 1225107873
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Entity Type | Individual
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Provider Name | THOMAS W WATKINS O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 107 ISLAND ST
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City | HARLAN
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State | KY
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Zip | 40831-1904
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Country | US
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Telephone | 606-573-7447
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Fax | 606-573-7930
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Provider Business Mailing Address
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Address Line | 701 W CITY DAM RD
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City | KEAVY
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State | KY
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Zip | 40737-2607
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Country | US
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Telephone | 606-231-0960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1186DT
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License Number State | KY
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