Individual
KENNETH DALE WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
108 E HOSPITAL DR, WINCHESTER, IN 47394-2223
(765) 584-1639
(765) 584-4711
Mailing address
108 E HOSPITAL DR, WINCHESTER, IN 47394-2223
(765) 584-1639
(765) 584-4711
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028715
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100127560A
—
IN
Enumeration date
08/18/2005
Last updated
06/13/2011
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