MEDICARE: CHRISTINE KIRKENDOL WATSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	01055140A	IN
2	207R00000X	Internal Medicine Physician	01055140A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000752103	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053361196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE KIRKENDOL WATSON M.D.

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7250 CLEARVISTA DRIVE
Second Line	:	SUITE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4640
Country	:	US
Telephone Number	:	317-621-5673
Fax Number	:	317-621-6040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	04/03/2020

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Directions to “ CHRISTINE KIRKENDOL WATSON M.D.” Practice Location

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