Individual
WILLIAM JUAN WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 LINE AVE, SHREVEPORT, LA 71104-2126
(318) 226-9441
(318) 425-3236
Mailing address
2121 LINE AVE, SHREVEPORT, LA 71104-2126
(318) 226-9441
(318) 425-3236
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
009207
LA
207YX0602X
Otolaryngic Allergy Physician
009207
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063584
—
LA
Enumeration date
06/22/2005
Last updated
09/23/2010
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