Individual
DR. KEVIN T WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6000
Mailing address
213 SMOKERISE TRCE, PEACHTREE CITY, GA 30269-6626
(678) 884-6778
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
234159
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02604891
—
NY
01
—
3696H2
EMPIRE BC.BS
NY
01
—
7959590
AETNA
NY
Enumeration date
07/19/2006
Last updated
06/23/2021
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