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Individual

JILL R WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3900 KRESGE WAY, SUITE 54, LOUISVILLE, KY 40207-4660
(502) 896-6696
(502) 896-1795
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39683
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200529550
IN
05
64109549
KY
Enumeration date
04/19/2006
Last updated
12/10/2020
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