Organization
WATKINS FOOT AND ANKLE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD C WATKINS D.P.M. (CEO)
(352) 805-4317
Entity
Organization
Contact information
Practice address
914 E DIXIE AVE, LEESBURG, FL 34748-7647
(352) 805-4317
(352) 805-4298
Mailing address
914 E DIXIE AVE, LEESBURG, FL 34748-7647
(352) 805-4317
(352) 805-4298
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2769
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174514194
NPI
FL
05
—
390469500
—
FL
Enumeration date
11/16/2016
Last updated
10/01/2018
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