Individual
DR. JEANE PALMER WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9168
(702) 791-9242
Mailing address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9168
(702) 791-9242
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
601
SC
213E00000X
Podiatrist
POD001066
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001066
GA
213ES0131X
Foot Surgery Podiatrist
601
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355230972A
—
GA
01
—
511I480052
INDIVIDUAL MEDICARE PTAN
GA
01
—
AA39819277
INDIVIDUAL MEDICARE PTAN
SC
01
—
P00884480
RAILROAD MEDICARE PROVIDER PTAN
GA
Enumeration date
04/27/2008
Last updated
07/24/2024
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