Provider Demographics
NPI:1346214012
Name:WATKINS, ROY W (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:W
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 MENDENHALL OAKS PKWY
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8034
Mailing Address - Country:US
Mailing Address - Phone:336-841-1259
Mailing Address - Fax:336-841-7595
Practice Address - Street 1:4140 MENDENHALL OAKS PKWY
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8034
Practice Address - Country:US
Practice Address - Phone:336-841-1259
Practice Address - Fax:336-841-7595
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7985935Medicaid
NCE10603Medicare UPIN
NC2139922CMedicare ID - Type UnspecifiedMEDICARE NUMBER