Provider Demographics
NPI:1548290133
Name:WATKINS, LEON T (DPM)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:T
Last Name:WATKINS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 HARVARD AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1172
Mailing Address - Country:US
Mailing Address - Phone:504-454-3004
Mailing Address - Fax:504-454-3075
Practice Address - Street 1:2520 HARVARD AVE FL 1
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1172
Practice Address - Country:US
Practice Address - Phone:504-454-3004
Practice Address - Fax:504-454-3075
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD163R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1699896Medicaid
LAU61914Medicare UPIN
LA1699896Medicaid