| Doctor Name: | TIMOTHY R WATSON |
| NPI Number: | 1003285461 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | 95003063 |
| Business Practice Address: | Acute Care And Family Clininc 351 Peoples Dr 351 Peoples Dr Pontotoc, MS - 38863 |
| Business Phone Number: | 6624892777 |
| Business Fax Number: | |
| Mailing Address: | 11 Cr 4091, OXFORD |
| State: | MS |
| Postal Code: | 38655 |
| Phone Number: | 2516049639 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2015 |
| NPI Last Update Date: | 02/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 95003063 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |