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General NPI Number Information
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NPI Number | 1326240425
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Entity Type | Individual
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Provider Name | BRUCE JAMES WATKINS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1542 ELK CREEK DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8322
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Country | US
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Telephone | 844-919-4263
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Fax | 833-513-0980
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Provider Business Mailing Address
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Address Line | 1542 ELK CREEK DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8322
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Country | US
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Telephone | 844-919-4263
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Fax | 833-513-0980
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 80664388017
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 48738-020
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 8873
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | M-13763
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License Number State | ID
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