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General NPI Number Information
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NPI Number | 1104884998
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Entity Type | Individual
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Provider Name | DOUGLAS ELRY WATFORD MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 02/08/2026
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Provider Practice Location Address
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Address Line | 400 GLENWOOD AVE STE 3
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City | KINSTON
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State | NC
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Zip | 28501
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Country | US
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Telephone | 252-527-8906
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Fax | 252-527-9816
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Provider Business Mailing Address
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Address Line | PO BOX 5281
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City | KINSTON
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State | NC
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Zip | 28503
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Country | US
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Telephone | 252-527-8906
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Fax | 252-527-9816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35546
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License Number State | NC
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