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Individual

DR. LAWRENCE J. WATTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
403 FAIRVIEW ST, CLINTON, NC 28328-2399
(910) 592-0611
(910) 592-0817
Mailing address
403 FAIRVIEW ST, CLINTON, NC 28328-2311
(910) 592-6011

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
97-001194
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00375846
NC
01
0138736
UNITED HEALTHCARE
NC
01
1068V
NC BLUE CROSS BLUE SHIELD
NC
01
560955090J
CIGNA
NC
01
7193363
AETNA
NC
01
75750
MEDCOST
NC
Enumeration date
06/20/2006
Last updated
10/18/2019
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