| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 02/09/2012 |
| Last Update Date | 03/29/2024 |
| Certification Date | 03/29/2024 |
| Medicare PECOS PAC ID | 0648439349 |
|---|---|
| Medicare Enrollment ID | O20120316000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235401043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Angela D Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275601346 PECOS PAC ID: 5092603050 Enrollment ID: I20040310000399 |
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