Dr Kelly Nicole Watson, MD | |
305 W Robinson Ave, Grovetown, GA 30813-2145 | |
(706) 446-4886 | |
Not Available |
Full Name | Dr Kelly Nicole Watson |
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Gender | Female |
Speciality | Pediatrics |
Location | 305 W Robinson Ave, Grovetown, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740401835 | NPI | - | NPPES |
000519 | Other | GA | RESIDING TRAING PERMIT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 82677 (Georgia) | Primary |
Entity Name | Au Medical Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841230620 PECOS PAC ID: 9931013513 Enrollment ID: O20040107000188 |
Entity Name | Wellstar Medical Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
Mailing Address | Practice Location Address |
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Dr Kelly Nicole Watson, MD 1120 15th St # Bi1056, Augusta, GA 30912-0004 Ph: (706) 721-8623 | Dr Kelly Nicole Watson, MD 305 W Robinson Ave, Grovetown, GA 30813-2145 Ph: (706) 446-4886 |
Jill Wheeler Kitchens, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5135 Wrightsboro Rd Ste B, Grovetown, GA 30813 Phone: 706-854-2500 Fax: 706-854-2500 | |
Dr. Quan Johnson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5135 Wrightsboro Rd Ste B, Grovetown, GA 30813 Phone: 706-854-2500 Fax: 706-854-2559 |