Individual
MRS. JESSICA LEIGH WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2114 HIGHWAY 41 STE 105, MOUNT PLEASANT, SC 29466
(843) 388-9000
(843) 388-6937
Mailing address
2114 HIGHWAY 41 STE 105, MOUNT PLEASANT, SC 29466-6201
(843) 388-9000
(843) 388-6937
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2054
SC
363AM0700X
Medical Physician Assistant
C0004103
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1848PA
—
SC
01
—
SC3066I711
MEDICARE PIN
SC
Enumeration date
11/18/2009
Last updated
03/31/2022
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