Provider Demographics
NPI:1871029827
Name:WATSON, CHRISTOPHER (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13245 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-5963
Mailing Address - Country:US
Mailing Address - Phone:276-466-4727
Mailing Address - Fax:276-466-4733
Practice Address - Street 1:13245 LEE HWY
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-5963
Practice Address - Country:US
Practice Address - Phone:276-466-4727
Practice Address - Fax:276-466-4733
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207010183500000X
TN0000024435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202207010OtherVIRGINIA PHARMACY LICENSE
TN0000024435OtherTENNESSE PHARMACIST LICENSE