Provider Demographics
NPI:1982919858
Name:WATKINS, WILLIAM DAVID (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DAVID
Last Name:WATKINS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12510 S 175TH AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5762
Mailing Address - Country:US
Mailing Address - Phone:623-293-0372
Mailing Address - Fax:623-877-3193
Practice Address - Street 1:9045 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-2029
Practice Address - Country:US
Practice Address - Phone:623-877-3186
Practice Address - Fax:623-877-3193
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist