Provider Demographics
NPI:1326220559
Name:WATKINS, KIRK GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:GRANT
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:251 HILTON DR
Mailing Address - Street 2:#107
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2320
Mailing Address - Country:US
Mailing Address - Phone:435-634-9630
Mailing Address - Fax:435-634-9622
Practice Address - Street 1:251 HILTON DR
Practice Address - Street 2:#107
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2320
Practice Address - Country:US
Practice Address - Phone:435-634-9630
Practice Address - Fax:435-634-9622
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2016-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT325420-1205207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT528066321022Medicaid
UTG66828Medicare UPIN
UT005705201Medicare PIN