Provider Demographics
NPI:1922039221
Name:DAVIS-WATTS, MICHELLE LEA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEA
Last Name:DAVIS-WATTS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1670 CLAIRMONT RD
Mailing Address - Street 2:MAIL CODE 111
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4004
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:404-329-2211
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:MAIL CODE 111
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-329-2211
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA003224363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant