Individual
ANGELA D WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3445 POPLAR AVE STE 13, MEMPHIS, TN 38111-4667
(901) 276-2357
(901) 276-2359
Mailing address
PO BOX 42013, MEMPHIS, TN 38174-2013
(901) 276-2357
(901) 276-2359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1489
TN
207R00000X
Internal Medicine Physician
18099
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1416612
BCBS, BLUE CARE, TENNCARE SELECT
TN
05
—
3717056
—
TN
01
—
4074254
BCBSTN
TN
01
—
P00156491
RAILROAD MEDICARE
TN
Enumeration date
11/30/2006
Last updated
03/29/2024
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