Individual
DOUGLAS LEE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2855 CHARLESTOWN RD, NEW ALBANY, IN 47150-2691
(502) 265-5866
(765) 308-5660
Mailing address
2855 CHARLESTOWN RD, NEW ALBANY, IN 47150-2691
(502) 265-5866
(765) 308-5660
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
1030062854
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71013479A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300010664
—
IN
05
—
7100535740
—
KY
01
—
IN3604
MEDICARE
IN
01
—
K258180
MEDICARE
KY
Enumeration date
08/09/2022
Last updated
01/22/2025
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