Individual
ANDREA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 RING RD, ELIZABETHTOWN, KY 42701-4900
(270) 706-1925
(270) 706-1926
Mailing address
1700 RING RD, ELIZABETHTOWN, KY 42701-9497
(270) 769-5551
(270) 982-2128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44759
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100164040
—
KY
Enumeration date
03/02/2009
Last updated
05/25/2012
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