Watson, John Devin Blackwell

Watson, John Devin Blackwell is an individual health care provider with primary practice located at 301 Fisher St , Keesler Afb MS 39534-2508. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Watson, John Devin Blackwell can be contacted via phone (702) 460-1720.

Contact Information

Primary practice address
301 Fisher St Keesler Afb MS 39534-2508
Phone: (702) 460-1720
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101251335 Virginia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 0101251335 Virginia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 28756 Mississippi

Profile Details

NPI number 1386969137
LBN Legal business name Watson, John Devin Blackwell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2010
Last updated Jan 15th, 2024 - about 2 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 1386969137 NPPES
Mississippi MEDICAID 01802274

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