Provider Demographics
NPI:1447215371
Name:WATKINS, CHRISTOPHER S (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:S
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 780982
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0982
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:200 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1831
Practice Address - Country:US
Practice Address - Phone:502-629-8000
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32170207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5145390OtherCIGNA / CMA DBA
KY64321706Medicaid
000000350754OtherANTHEM / CMA DBA
019327OtherSIHO / CMA DBA
2440458000OtherPASSPORT ADVANTAGE / CMA DBA
1169467OtherPASSPORT / CMA DBA
000052152DOtherHUMANA / CMA DBA
KYP00332737OtherRAILROAD MEDICARE
IN200426460Medicaid
IN200426460Medicaid
KY0361971Medicare PIN