Provider Demographics
NPI:1427345255
Name:WATT, CHRISTINA HOPE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:HOPE
Last Name:WATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WATSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31028-1771
Mailing Address - Country:US
Mailing Address - Phone:478-953-2006
Mailing Address - Fax:478-953-9425
Practice Address - Street 1:2900 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:GA
Practice Address - Zip Code:31028-1771
Practice Address - Country:US
Practice Address - Phone:478-953-2006
Practice Address - Fax:478-953-9425
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHTC002905183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician