MEDICARE: DR. KATHARINE WATSON SANDERS MD

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	208D00000X	General Practice Physician	020695	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	202I011354	OTHER	GA	MEDICARE PTAN

General Provider Information

NPI Number	:	1164441150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHARINE WATSON SANDERS MD

Provider Business Mailing Address
First Line	:	PO BOX 608
Second Line	:
City	:	WASHINGTON
State	:	GA
Zip	:	30673-0608
Country	:	US
Telephone Number	:	706-678-3793
Fax Number	:	706-418-8148

Provider Business Practice Location Address
First Line	:	124 GORDON ST
Second Line	:
City	:	WASHINGTON
State	:	GA
Zip	:	30673-1602
Country	:	US
Telephone Number	:	706-678-3793
Fax Number	:	706-418-8148

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	04/29/2026

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