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NPI Code Detail

MEDICARE: JERILYN WATSON M.D.

MEDICARE:   JERILYN  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
1207R00000XInternal Medicine Physician30995AZ

General Provider Information

NPI Number : 1871589986
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERILYN WATSON M.D.
Provider Business Mailing Address
First Line : PO BOX 28757
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-0162
Country : US
Telephone Number : 602-550-0724
Fax Number : 480-636-7642
Provider Business Practice Location Address
First Line : 2528 W VIA PERUGIA
Second Line :
City : PHOENIX
State : AZ
Zip : 85086-6630
Country : US
Telephone Number : 602-550-0724
Fax Number : 480-636-7642
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 02/20/2018

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Directions to “ JERILYN WATSON M.D.” Practice Location

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