Basic Information
| Provider Information | |||||||||
| NPI: | 1407233158 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WATKINS | ||||||||
| FirstName: | FORREST | ||||||||
| MiddleName: | HARMON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 PILOT MEDICAL DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352353412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058562284 | ||||||||
| FaxNumber: | 2058154777 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 PILOT MEDICAL DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352353412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058562284 | ||||||||
| FaxNumber: | 2058154777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2015 | ||||||||
| LastUpdateDate: | 06/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2100X | 1-136808 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Acute Care |
No ID Information.