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NPI Code Detail

MEDICARE: DR. ALYSSA A WATKINS MD, IBCLC, FAAP

MEDICARE: DR. ALYSSA A WATKINS MD, IBCLC, FAAP
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
1208000000XPediatrics Physician04-37188KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14108813OTHERUNITED HEALTHCARE
21265728877OTHERTRIWEST/TRICARE
31265728877OTHERBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
51265728877OTHERHEALTH PARTNERS OF KANSAS

General Provider Information

NPI Number : 1265728877
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYSSA A WATKINS MD, IBCLC, FAAP
Provider Business Mailing Address
First Line : PO BOX 725
Second Line :
City : NEWTON
State : KS
Zip : 67114-0725
Country : US
Telephone Number : 316-283-3627
Fax Number : 316-283-3635
Provider Business Practice Location Address
First Line : 700 MEDICAL CENTER DRIVE
Second Line : STE 150
City : NEWTON
State : KS
Zip : 67114-9015
Country : US
Telephone Number : 316-283-7100
Fax Number : 316-283-7118
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2011
Last Update Date : 11/16/2022

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