NPI 1164087698

Jimmy Watts

Practitioner Pharmacist Marianna, FL

Practice location

Address: 4314 5th Ave, Marianna, FL 32446-2182
Phone: (850) 482-3924

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence PS14142 (FL)

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Registry record

NPI: 1164087698
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 May 2019
Record last updated: 9 May 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.