Individual
ANA LIDIA WERNER WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-2225
(217) 258-2367
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
036.158997
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036.158997
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
266103
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
50508
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100457630
—
KY
Enumeration date
06/10/2009
Last updated
07/10/2024
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