Timothy R Watson, FNP-C
Nurse Practitioner, Family in Pontotoc, MS. Individual provider (NPI-1).
NPI number1003285461
StatusActive
Last updated in NPPESFeb 23, 2016
Details
- NPI
- 1003285461
- Entity type
- Individual (NPI-1)
- Name
- Timothy R Watson
- Credential
- FNP-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 16, 2015
- Last updated
- Feb 23, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95003063 | CA | Yes |
| 363LP2300X | Nurse Practitioner, Primary Care | 95003063 | CA |
Practice location
Acute Care And Family Clininc 351 Peoples Dr351 Peoples Dr
Pontotoc, MS 38863
Phone 662-489-2777
Mailing address
11 Cr 4091Oxford, MS 38655
Phone 251-604-9639
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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