Provider Demographics
NPI:1588995179
Name:WATKINS, LAURA ALICE (MD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ALICE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 WALNUT ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1168
Mailing Address - Country:US
Mailing Address - Phone:717-988-0090
Mailing Address - Fax:717-221-5320
Practice Address - Street 1:3 WALNUT ST STE 205
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1168
Practice Address - Country:US
Practice Address - Phone:717-988-0090
Practice Address - Fax:717-221-5320
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2634962080P0203X
PAMD4349612080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine