| Dia Watson, PA-C | |
|
2010 Active Way, Bryant, AR 72022-9267 | |
| (501) 315-0984 | |
| (501) 847-1405 |
| Full Name | Dia Watson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2010 Active Way, Bryant, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609290220 | NPI | - | NPPES |
| PA540 | Other | AR | ARKANSAS STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA540 (Arkansas) | Primary |
| 363AM0700X | Physician Assistant - Medical | PA-540 (Arkansas) | Secondary |
| Entity Name | Saline Orthopedic Group P a |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093825002 PECOS PAC ID: 7911819479 Enrollment ID: O20031103000555 |
| Entity Name | Gastro Clinics of Arkansas PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972944064 PECOS PAC ID: 5496983363 Enrollment ID: O20140123000109 |
| Mailing Address | Practice Location Address |
|---|---|
| Dia Watson, PA-C 2010 Active Way, Benton, AR 72022-9267 Ph: (501) 315-0984 | Dia Watson, PA-C 2010 Active Way, Bryant, AR 72022-9267 Ph: (501) 315-0984 |
Mr. Bruce E. Whitwell, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 23150 I 30, Bryant, AR 72022 Phone: 501-888-9047 Fax: 501-213-0531 |
Nicholas Crump, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 Active Way, Bryant, AR 72022 Phone: 501-315-0984 Fax: 501-847-1405 |
Maleah A Paulovich, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1901 Encore Way, Bryant, AR 72019 Phone: 501-213-4500 Fax: 501-686-8586 |