Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 022795 | LA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 022795 | LA |
NPI | 1003812009 |
---|---|
Provider Name | William Harrel Watkins |
First Address | Shreveport, LA 71104-2126 |
Second Address | Shreveport, LA 71104-2126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1687464 | (05) | LA |
G39283 | (02) |