Individual
CARTER WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-2022
Mailing address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-2022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18640
MS
208M00000X
Hospitalist Physician
18640
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01532506
—
MS
Enumeration date
08/08/2006
Last updated
02/01/2008
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