Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ORT0000000069 | TN |
N | 222Z00000X | Podiatrist | ORT0000000069 | TN |
Y | 224P00000X | Prosthetist | PRO0000000058 | TN |
NPI | 1215277728 |
---|---|
Provider Name | Mr. Mark A Watson |
First Address | Nashville, TN 37203-2929 |
Second Address | Nashville, TN 37203-2929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2013 |
Last Update Date | 20/02/2013 |