Individual
JASON LEE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
133 N HOWARD AVE, LANDRUM, SC 29356-1507
(864) 457-3838
(864) 560-9532
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TL30486
SC
207Q00000X
Family Medicine Physician
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900329
—
NC
05
—
N00433
—
SC
Enumeration date
05/01/2006
Last updated
01/31/2008
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