Individual
MR. TIMOTHY B WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1127 EARL FRYE BLVD, SUITE A, AMORY, MS 38821-5516
(662) 257-2324
(662) 257-2325
Mailing address
123 MAIN ST N, AMORY, MS 38821-3416
(662) 256-7112
(662) 256-7116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R858312
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125157/9013761
—
MS
Enumeration date
09/20/2006
Last updated
07/12/2021
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