Individual
MR. BENJAMIN P WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.H.S., PA-C
Contact information
Practice address
3615 HOSPITAL ST, PASCAGOULA, MS 39581-4112
(228) 762-3664
(228) 769-7015
Mailing address
6300 E LAKE BLVD, STE. 301, VANCLEAVE, MS 39565-6770
(228) 230-2663
(228) 206-1192
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA-183
AL
363AS0400X
Surgical Physician Assistant
Primary
PA00164
MS
Other
Enumeration date
11/07/2005
Last updated
03/22/2017
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