Provider Demographics
NPI:1346307345
Name:WATSON, JAMEY CLAY
Entity type:Individual
Prefix:
First Name:JAMEY
Middle Name:CLAY
Last Name:WATSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 BLUE SPRING RD NW STE F
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-3457
Mailing Address - Country:US
Mailing Address - Phone:256-852-9994
Mailing Address - Fax:
Practice Address - Street 1:3700 BLUE SPRING RD NW STE F
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3457
Practice Address - Country:US
Practice Address - Phone:256-852-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5145396-99211223X0400X
ALD.007436-C1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics