Provider Demographics
NPI:1053377937
Name:WATKINS, STEVEN K (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:WATKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:908 N ROCKFORD RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-2540
Mailing Address - Country:US
Mailing Address - Phone:580-490-9411
Mailing Address - Fax:580-490-9415
Practice Address - Street 1:908 N ROCKFORD RD
Practice Address - Street 2:SUITE G
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2540
Practice Address - Country:US
Practice Address - Phone:580-490-9411
Practice Address - Fax:580-490-9415
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2014-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK4120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4120OtherOKLAHOMA LICENSE
OK371504728OtherTAX ID #
OKI28956Medicare UPIN
OK248533907Medicare PIN