Individual
CHRISTINE KIRKENDOL WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7250 CLEARVISTA DRIVE, SUITE 100, INDIANAPOLIS, IN 46256-4640
(317) 621-5673
(317) 621-6040
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01055140A
IN
207R00000X
Internal Medicine Physician
Primary
01055140A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000752103
ANTHEM
IN
05
—
200414940F
—
IN
Enumeration date
05/11/2006
Last updated
04/03/2020
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