Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 65626 | GA |
NPI | 1033384805 |
---|---|
Provider Name | Benjamin Keen Watkins |
First Address | Atlanta, GA 30322-1014 |
Second Address | Atlanta, GA 30322-1014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2008 |
Last Update Date | 12/05/2014 |