Individual
KENNETH MAXWELL WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 765-4132
Mailing address
855 MULBERRY ST APT 202, MACON, GA 31201-6750
(678) 542-8581
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
222836
GA
367500000X
Certified Registered Nurse Anesthetist
25200
TN
Other
Enumeration date
01/04/2018
Last updated
12/14/2023
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