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NPI Code Detail

MEDICARE: MR. JOSEPH KENNETH WATSON JR.

MEDICARE: MR. JOSEPH KENNETH WATSON JR.
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1942142054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH KENNETH WATSON JR.
Provider Business Mailing Address
First Line : 765 PINE GROVE CHURCH RD
Second Line :
City : CULLODEN
State : GA
Zip : 31016-5648
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 302 TYSON AVE STE B
Second Line :
City : PARIS
State : TN
Zip : 38242-4555
Country : US
Telephone Number : 731-407-7650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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