MEDICARE: DR. EMILY GRACE WATSON

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	183500000X	Pharmacist	45542	TN

General Provider Information

NPI Number	:	1205597390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY GRACE WATSON

Provider Business Mailing Address
First Line	:	2399 MCGRADY DR SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-7147
Country	:	US
Telephone Number	:	423-559-9094
Fax Number	:

Provider Business Practice Location Address
First Line	:	2399 MCGRADY DR SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-7147
Country	:	US
Telephone Number	:	423-559-9094
Fax Number	:

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

Provider Enumeration Date	:	01/01/2022
Last Update Date	:	01/01/2022

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Directions to “ DR. EMILY GRACE WATSON ” Practice Location

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