Provider Demographics
NPI:1427876457
Name:WATKINS, MOLLY E (RDMS (OB))
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:E
Last Name:WATKINS
Suffix:
Gender:F
Credentials:RDMS (OB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2073 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6774
Mailing Address - Country:US
Mailing Address - Phone:208-731-4168
Mailing Address - Fax:
Practice Address - Street 1:2073 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6774
Practice Address - Country:US
Practice Address - Phone:208-731-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1224992085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound