Provider Demographics
NPI:1346514650
Name:WATKINS TOTAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:WATKINS TOTAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-534-0656
Mailing Address - Street 1:961 GREEN ST NW
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3325
Mailing Address - Country:US
Mailing Address - Phone:770-534-0656
Mailing Address - Fax:
Practice Address - Street 1:961 GREEN ST NW
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3325
Practice Address - Country:US
Practice Address - Phone:770-534-0656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIVE COUMMINTY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111N00000X, 207QA0505X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty