Individual
LISA ANN RUDOLPH-WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 891-9131
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
17946
WV
Other
Enumeration date
07/10/2006
Last updated
09/08/2025
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