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Individual

DOUGLAS J WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 229-4917
(320) 229-5181
Mailing address
3366 OAKDALE AVENUE NO, #315 NORTH CLINIC PA, ROBBINSDALE, MN 55422-2948
(763) 587-7900
(763) 587-7989

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
31999
MN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
31999
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0707716
MEDICA HEALTH PLANS
01
080073015
RAILROAD MEDICARE
01
110935
U-CARE
01
2114087
FIRST HEALTH PLAN
01
438598
PREFERRED ONE
01
601023
ARAZ GROUP/AMERICAS PPO
01
761592200
MEDICAL ASSISTANCE (MA)
05
761592200
MN
01
86D81WA
BLUE CROSS BLUE SHIELD
01
COMP
CHAMPUS
01
HP22747
HEALTH PARTNERS
Enumeration date
10/25/2005
Last updated
05/26/2010
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