MR. KENNETH LEE WATSON NPI 1699090993

NPI Information

  • NPI: 1699090993
  • Provider Name: MR. KENNETH LEE WATSON
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3401 N BROAD ST
    PHILADELPHIA, PA
    ZIP 19140
  • Phone: (215) 707-3133

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NPI Details

MR. Kenneth Lee Watson is a medical physician assistant in Philadelphia, PA with 10 years of experience. MR. Kenneth Lee Watson NPI is 1699090993. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3401 N BROAD ST
PHILADELPHIA, PA
ZIP 19140-103
Phone: (215) 707-3133
Fax: (215) 707-3945

The NPI 1699090993 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/30/2010 and was last updated on 3/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225200000XPhysical Therapy AssistantTEI002569PENNSYLVANIANo
2363A00000XPhysician Assistant25MP00409400NEW JERSEYNo
3363AM0700XPhysician AssistantMedicalMA060559PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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