Individual
WILLIAM MARVIN WATKINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5017
(601) 984-5042
Mailing address
2500 N STATE ST, DEPT OF OPHTHALMOLOGY, JACKSON, MS 39216-4500
(601) 984-5017
(601) 984-5042
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
22666
MS
208600000X
Surgery Physician
AU5009697-1595
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03407352
—
MS
01
—
P01454871
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/14/2009
Last updated
06/18/2015
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