Active NPI
William Juan Watkins, M.D.
- Otolaryngology Physician
- Shreveport, LA
National Provider Identifier
1932105327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 009207
- Practice address
- 2121 Line Ave
Shreveport, LA 71104-2126 - Phone
- (318) 226-9441
- Fax
- (318) 425-3236
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 009207 | LA | Primary |
| Otolaryngic Allergy Physician | 207YX0602X | 009207 | LA |
Addresses
Primary practice location
2121 Line Ave
Shreveport, LA 71104-2126
Mailing address
2121 Line Ave
Shreveport, LA 71104-2126
Phone (318) 226-9441
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063584 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009207 | LA | MD | Otolaryngic Allergy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285200000000",
"number": "1932105327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 LINE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042126",
"telephone_number": "318-226-9441",
"fax_number": "318-425-3236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 LINE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042126",
"telephone_number": "318-226-9441",
"fax_number": "318-425-3236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "WILLIAM",
"middle_name": "JUAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2010-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "LA",
"license": "009207",
"primary": true
},
{
"code": "207YX0602X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngic Allergy",
"state": "LA",
"license": "009207",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1063584",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.