Individual
KENNETH IRA WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL EMERGENCY MEDICINE, HARTFORD, CT 06102-5037
(860) 972-0000
Mailing address
80 SEYMOUR STREET, HARTFORD HOSPITAL EMERGENCY MEDICINE, HARTFORD, CT 06102-5037
(860) 972-0000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000817
CT
363AM0700X
Medical Physician Assistant
Primary
000817
CT
363AS0400X
Surgical Physician Assistant
000817
CT
Other
Enumeration date
07/20/2005
Last updated
11/10/2015
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