Organization
GASTONIA PEDIATRIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C WATTS,III M.D. (VICE PRESIDENT)
(704) 864-2685
Entity
Organization
Contact information
Practice address
1839 E GARRISON BLVD, GASTONIA, NC 28054-4839
(704) 864-2685
(704) 864-9363
Mailing address
1839 E GARRISON BLVD, GASTONIA, NC 28054-4839
(704) 864-2685
(704) 864-9363
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901611
—
NC
Enumeration date
09/13/2005
Last updated
06/04/2013
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