Provider Demographics
NPI:1962715003
Name:ROBERT E WATKINS JR DC INC
Entity type:Organization
Organization Name:ROBERT E WATKINS JR DC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:239-590-9555
Mailing Address - Street 1:6430 PLANTATION PARK CT STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-4815
Mailing Address - Country:US
Mailing Address - Phone:239-590-9555
Mailing Address - Fax:866-254-8158
Practice Address - Street 1:6430 PLANTATION PARK CT STE 100
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-4815
Practice Address - Country:US
Practice Address - Phone:239-590-9555
Practice Address - Fax:866-254-8158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty