GLEN LEE WATKINS (NPI# 1124023874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124023874 |
| Entity Type | Individual |
| Full Name | GLEN LEE WATKINS |
| Credential | M.D. |
| Practice Address |
1000 Chinaberry Dr Ste 1103 Bossier City LA 71111-2463 |
| Practice Telephone | 3187161111 |
| Practice Fax Number | 3187161112 |
| Mailing Telephone | 3187161111 |
| Mailing Fax Number | 3187161112 |
| Enumeration Date | 2005-06-19 |
| Last Update Date | 2020-10-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 205062 | LA | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | ME98502 | FL | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 050489 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 21744801 | 05 |
| Street Address |
1000 CHINABERRY DR STE 1103 |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71111-2463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1912538315 | Lagniappe Chiropractic | Chiropractor | 2400 Airline Drive, Bossier City, LA 71111 | 2020-02-04 |
| 1649817420 | Lifecare Medical Transportation, LLC. | Non-emergency Medical Transport (VAN) | 25 Duck Haven Pointe, Bossier City, LA 71111 | 2019-11-29 |
| 1770126344 | Bertresea White Evans | Nurse Practitioner | Coastal Urgernt Care, 5314 Airline Drive, Bossier City, LA 71111 | 2019-10-25 |
| 1861964058 | Erika Davis Reed | Counselor | 1515 Doctors Dr # 16, Bossier City, LA 71111 | 2018-12-28 |
| 1518436898 | Charlotte Mckay | Case Manager/Care Coordinator | 31330 Hwy 22, Ste 101, Bossier City, LA 71111 | 2018-11-16 |
| 1992271464 | Np2u, LLC | Nurse Practitioner | 2008 Airline Drive Suite 300 #194, Bossier City, LA 71111 | 2018-10-22 |
| 1114416542 | Lashaunda Autrey | Counselor | 410 Half Moon Lane, Bossier, LA 71111 | 2018-05-01 |
| 1750887196 | Shenya Williams-pennywell | Counselor | 1007 Gould Drive Bldg 2, Suite 1, Bossier City, LA 71111 | 2018-04-04 |
| 1336647304 | Patrick Vance | Physical Therapist | 5000 Benton Rd Ste 1, Bossier City, LA 71111 | 2018-01-24 |
| Find all providers in zip 71111 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851918486 | Wk Bossier Ent & Allergy Institute | Otolaryngology | 2449 Hospital Dr Ste 440, Bossier City, LA 71111-1918 | 2020-06-30 |
| 1851554885 | G. Keith Christy, M.d., Apmc | Otolaryngology | 2400 Hospital Dr Ste 260, Bossier City, LA 71111-2390 | 2008-07-09 |
| 1396779641 | Gilbert Keith Christy | Otolaryngology | 2400 Hospital Drive, Suite 260, Bossier City, LA 71111-2385 | 2006-07-11 |
| 1306805775 | Roy Murl Fleniken | Otolaryngology | 1527 Doctors Dr, Bossier City, LA 71111-3321 | 2006-03-22 |
| 1750340733 | Chandrakant M Joshi | Otolaryngology | 2211 Shed Rd, Bossier City, LA 71111-3637 | 2006-03-20 |
| 1356784359 | Wk Ctr for Ear Nose and Throat Disorders | Otolaryngology | 2300 Hospital Dr, Suite 460, Bossier City, LA 71111-2394 | 2013-04-10 |
| 1104195486 | Wk Center for Ear Nose and Throat Disorders | Otolaryngology | 2300 Hospital Dr, Suite 460, Bossier City, LA 71111-2394 | 2011-12-15 |
| 1487899696 | Wk North Bossier Ent | Otolaryngology | 2400 Hospital Dr, Ste 260, Bossier City, LA 71111-2385 | 2008-12-03 |
| 1396789749 | Willis-knighton Medical Center, Inc. | Otolaryngology | 2300 Hospital Dr, Suite 320, Bossier City, LA 71111-2394 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497352272 | Trahan Medical Corporation | Otolaryngology | 3935 I 49 S Service Rd, Opelousas, LA 70570-0758 | 2020-10-05 |
| 1144834177 | Compassio, LLC | Otolaryngology | 616 S Jahncke Ave, Covington, LA 70433-3719 | 2020-09-08 |
| 1356992119 | Keith F. Desonier, M.d, Apmc | Otolaryngology | 555 Dr Michael Debakey Dr Ste 103, Lake Charles, LA 70601-5700 | 2019-09-24 |
| 1366096950 | Harold Edward Zylicz II | Otolaryngology | 8585 Picardy Ave Ste 210, Baton Rouge, LA 70809-3749 | 2019-07-31 |
| 1477927838 | Smart Sinus and Allergy Louisiana LLC | Otolaryngology | 73100 E Stadium Dr, Covington, LA 70433-1008 | 2015-11-23 |
| 1336541226 | Dr. Charles J. Ballay II M.d. | Otolaryngology | 1111 Medical Center Blvd, 707 N, Marrero, LA 70072 | 2014-09-23 |
| 1124445093 | Elizabeth Gardner De Laureal | Otolaryngology | 200 W Esplanade Ave Ste 420, Kenner, LA 70065-2489 | 2014-03-27 |
| 1346680758 | Andrew Matthew Robichaux | Otolaryngology | 17609 Old Jefferson Hwy Ste C, Prairieville, LA 70769 | 2013-06-29 |
| 1184966962 | Rachel Alice Barry | Otolaryngology | 4212 W Congress St Ste 1500, Lafayette, LA 70506 | 2013-03-20 |
| 1568704328 | Jason Trahan | Otolaryngology | 3975 I 49 S Service Rd Ste 236, Opelousas, LA 70570-0776 | 2013-03-20 |
| Find all providers with the same taxonomy | ||||
| City | BOSSIER CITY |
| Zip Code | 71111 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.