Individual
KARYN R WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12903 SHELBYVILLE RD, LOUISVILLE, KY 40243-1538
(502) 244-5827
(502) 244-5829
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28073
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041703
SIHO - ICC
KY
05
—
300013432
—
IN
01
—
509829
ANTHEM - ICC
KY
05
—
64030497
—
KY
01
—
P00181549
RAILROAD MEDICARE
KY
Enumeration date
04/19/2006
Last updated
09/21/2022
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