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Individual

MRS. LARA B WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
35 COLLIER ROAD, NW, SUITE 610, ATLANTA, GA 30309
(404) 355-7375
(404) 350-9781
Mailing address
35 COLLIER ROAD, NW, SUITE 610, ATLANTA, GA 30309
(404) 355-7375
(404) 350-9781

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
050280
GA
207RN0300X
Nephrology Physician
Primary
050280
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
GA
Enumeration date
09/30/2005
Last updated
07/21/2009
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