Jeansonne, Susan Watts

Jeansonne, Susan Watts is an individual health care provider with primary practice located at 2002 Brookside Dr Suite 200, Kingsport TN 37660-4634. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Jeansonne, Susan Watts can be contacted via phone (423) 224-3933.

Contact Information

Primary practice address
2002 Brookside Dr Suite 200 Kingsport TN 37660-4634
Phone: (423) 224-3933
Fax: (423) 224-3934
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 40530 Tennessee
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD025360 Louisiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 40530 Tennessee

Profile Details

NPI number 1114913365
LBN Legal business name Jeansonne, Susan Watts
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Feb 10th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114913365 NPPES
Tennessee MEDICAID 1508394
Tennessee MEDICAID 1114913365

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