Provider Demographics
NPI:1275797649
Name:WATSON, ALESHIA LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALESHIA
Middle Name:LEWIS
Last Name:WATSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALESHIA
Other - Middle Name:CHARLENE
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4875 RIVERSIDE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1110
Mailing Address - Country:US
Mailing Address - Phone:478-812-9299
Mailing Address - Fax:478-812-9270
Practice Address - Street 1:4875 RIVERSIDE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1110
Practice Address - Country:US
Practice Address - Phone:478-812-9299
Practice Address - Fax:478-812-9270
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039263207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine