Individual
GREGORY SCOTT WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2855 CAMPUS DR, PLYMOUTH, MN 55441-2649
(763) 577-7179
Mailing address
2829 UNIVERSITY AVE SE STE 730, MINNEAPOLIS, MN 55414-3279
(612) 439-1867
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9194
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
448949700
—
MN
Enumeration date
07/24/2006
Last updated
01/17/2022
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