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Individual

DR. KELLY NICOLE WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
305 W ROBINSON AVE, GROVETOWN, GA 30813-2145
(706) 446-4886
Mailing address
1120 15TH ST # BI1056, AUGUSTA, GA 30912-0004
(706) 721-8623
(706) 721-1459

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
82677
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000519
RESIDING TRAING PERMIT
GA
Enumeration date
05/02/2007
Last updated
10/15/2024
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