Provider Demographics
NPI:1568012755
Name:WATCHMAN'S HEALTH PC
Entity type:Organization
Organization Name:WATCHMAN'S HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HAMMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-350-6182
Mailing Address - Street 1:1530 WOLVERINE DR SE STE D
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4950
Mailing Address - Country:US
Mailing Address - Phone:256-350-6182
Mailing Address - Fax:256-350-6184
Practice Address - Street 1:1530 WOLVERINE DR SE STE D
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4950
Practice Address - Country:US
Practice Address - Phone:256-350-6182
Practice Address - Fax:256-350-6184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1568012755OtherGROUP NPI
AL2609OtherPTAN