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NPI 1801313192

NPI 1801313192 : CLAIRE WATKINS PHYSICIAN ASSISTANT : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1801313192
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    Entity Type          |    Individual 
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    Provider Name        |    CLAIRE WATKINS PHYSICIAN ASSISTANT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/28/2017
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    Last Update Date     |    08/28/2017
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Provider Practice Location Address
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    Address Line         |    225 ABRAHAM FLEXNER WAY STE 700 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40202-3868
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    Country              |    US
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    Telephone            |    502-561-4263
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    Fax                  |    502-585-8478
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Provider Business Mailing Address
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    Address Line         |    225 ABRAHAM FLEXNER WAY STE 700 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40202-3868
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    Country              |    US
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    Telephone            |    502-417-0001
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    Fax                  |    502-585-8478
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    KY
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