Watson, Jerry E

Watson, Jerry E is an sole proprietor health care provider with primary practice located at 920 Doug White Dr Ste 510 , Myrtle Beach SC 29572-4120. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Watson, Jerry E can be contacted via phone (843) 497-7772.

Contact Information

Primary practice address
920 Doug White Dr Ste 510 Myrtle Beach SC 29572-4120
Phone: (843) 497-7772
Fax: (843) 848-7530
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 14980 South Carolina

Profile Details

NPI number 1174519896
LBN Legal business name Watson, Jerry E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2005
Last updated Feb 10th, 2020 - about 4 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 1174519896 NPPES
South Carolina MEDICAID 149805

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