Individual
KENNETH W WATSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015
(229) 276-3100
(229) 276-3306
Mailing address
PO BOX 5007, CORDELE, GA 31010
(229) 271-4656
(229) 271-4654
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R043600
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00550987E
—
GA
Enumeration date
02/10/2006
Last updated
07/08/2007
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