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NPI Code Detail

MEDICARE: DR. JOSEPH R WATKINS M.D.

MEDICARE: DR. JOSEPH R WATKINS M.D.
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
12084N0400XNeurology Physician1706651205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17246AOTHERWYWYOMING LICENSE

General Provider Information

NPI Number : 1659396695
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH R WATKINS M.D.
Provider Business Mailing Address
First Line : 1055 N 300 W STE 404
Second Line :
City : PROVO
State : UT
Zip : 84604-3359
Country : US
Telephone Number : 801-357-7401
Fax Number : 801-357-3708
Provider Business Practice Location Address
First Line : 1055 N 300 W STE 404
Second Line :
City : PROVO
State : UT
Zip : 84604-3359
Country : US
Telephone Number : 801-357-7401
Fax Number : 801-357-3708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 11/05/2013

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