Provider Demographics
NPI:1417905332
Name:WATKINS, SCOTT A (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
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:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:270-827-0064
Mailing Address - Fax:270-826-3338
Practice Address - Street 1:1300 MERRITT DR STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2788
Practice Address - Country:US
Practice Address - Phone:270-827-0064
Practice Address - Fax:270-826-3338
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048261A207R00000X
KY30537207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64305378Medicaid
337883OtherHEALTHLINK
000000042534OtherANTHEM
KY00756004Medicare PIN
KY64305378Medicaid
KY00626004Medicare PIN
KY0756301Medicare ID - Type UnspecifiedKY MCR
337883OtherHEALTHLINK
KY110146515Medicare ID - Type UnspecifiedKY RR MCR
G28154Medicare UPIN