Provider Demographics
NPI:1467486134
Name:WATKINS, PATRICIA N (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:N
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 BERMUDA CIR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2604
Mailing Address - Country:US
Mailing Address - Phone:706-736-1511
Mailing Address - Fax:
Practice Address - Street 1:3640 BERMUDA CIR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2604
Practice Address - Country:US
Practice Address - Phone:706-736-1511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC121882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC413093Medicaid
SC413093Medicaid
D41333Medicare UPIN