MEDICARE: TRACI N WATKINS MD

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
1	207Q00000X	Family Medicine Physician	35074048	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03491	OTHER		PARAMOUNT
2	080161014	OTHER	OH	RRMC
3	000000141223	OTHER	OH	ANTHEM
4	01-04929	OTHER	OH	UHC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2313822	OTHER	OH	AETNA
7	203089	OTHER	OH	BLACK LUNG

General Provider Information

NPI Number	:	1689667669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI N WATKINS MD

Provider Business Mailing Address
First Line	:	3909 WOODLEY RD
Second Line	:	SUITE 500
City	:	TOLEDO
State	:	OH
Zip	:	43606-1169
Country	:	US
Telephone Number	:	419-291-2670
Fax Number	:	419-479-6017

Provider Business Practice Location Address
First Line	:	3909 WOODLEY RD
Second Line	:	SUITE 500
City	:	TOLEDO
State	:	OH
Zip	:	43606-1169
Country	:	US
Telephone Number	:	419-291-2670
Fax Number	:	419-479-6017

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	11/03/2023

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Directions to “ TRACI N WATKINS MD” Practice Location

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