Basic Information
| Provider Information | |||||||||
| NPI: | 1972641074 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WATKINS | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 14TH AVE N | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372033416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153215698 | ||||||||
| FaxNumber: | 6153215538 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 14TH AVE N | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372033416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153215698 | ||||||||
| FaxNumber: | 6153215538 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 12/04/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 200301189 | NC | N | Allopathic & Osteopathic Physicians | General Practice | 2083X0100X | 42054 | TN | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | 2083X0100X | 20305 | MS | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.