Watson Advanced Care, Llc | |
3445 Poplar Ave Ste 13 Memphis TN 38111-4667 | |
(901) 233-2667 | |
(901) 276-2357 |
Full Name | Watson Advanced Care, Llc |
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Speciality | Internal Medicine |
Location | 3445 Poplar Ave Ste 13, Memphis, Tennessee |
Authorized Official Name and Position | Angela D Watson (OWNER) |
Authorized Official Contact | 9012332667 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Watson Advanced Care, Llc Po Box 42013 Memphis TN 38174-2013 Ph: (901) 233-2667 | Watson Advanced Care, Llc 3445 Poplar Ave Ste 13 Memphis TN 38111-4667 Ph: (901) 233-2667 |
NPI Number | 1235401043 |
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Provider Enumeration Date | 02/09/2012 |
Last Update Date | 03/29/2024 |
Medicare PECOS PAC ID | 0648439349 |
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Medicare Enrollment ID | O20120316000129 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235401043 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Angela D Watson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275601346 PECOS PAC ID: 5092603050 Enrollment ID: I20040310000399 |
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