Provider Demographics
NPI:1790738920
Name:WATSON, EMILY MAYS (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MAYS
Last Name:WATSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6061
Practice Address - Street 1:613 23RD ST STE 340
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2879
Practice Address - Country:US
Practice Address - Phone:606-326-9441
Practice Address - Fax:606-326-0404
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA593363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000327346OtherBLUE CROSS
KY00031004OtherMEDICARE
KY00031004OtherMEDICARE
KYP48158Medicare UPIN
KY00031004OtherMEDICARE