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Individual

WALTER WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3000 HOSPITAL BLVD, ROSWELL, GA 30076-4915
(770) 751-2567
Mailing address
5665 NEW NORTHSIDE DR NW, ATLANTA, GA 30328-5831
(770) 874-5400

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
029260
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000425576C
GA
Enumeration date
09/25/2006
Last updated
07/09/2007
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