Individual
MATTHEW J WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 851-6936
Mailing address
PO BOX 2968, KENNESAW, GA 30156-9117
(770) 779-0015
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
049822
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000917727
—
GA
05
—
000917727H
—
GA
05
—
000917727I
—
GA
01
—
008892
BCBS
GA
01
—
10038154
AMERIGROUP
GA
01
—
10654
KAISER
GA
01
—
298003
BCBS
GA
01
—
333417
WELLCARE
GA
Enumeration date
02/15/2006
Last updated
12/08/2008
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