Organization
KENNETH D WATKINS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH D WATKINS MD (OWNER)
(765) 584-1639
Entity
Organization
Contact information
Practice address
108 E HOSPITAL DR, WINCHESTER, IN 47394-2223
(765) 584-1639
(765) 584-4711
Mailing address
108 E HOSPITAL DR, WINCHESTER, IN 47394-2223
(765) 584-1639
(765) 584-4711
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028715
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000008478
ANTHEM
IN
01
—
169670
REGULAR MEDICARE
IN
05
—
200399280A
—
IN
Enumeration date
05/29/2007
Last updated
10/05/2011
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