LAKEISHA JOYCE BLAIR-WATSON (NPI# 1073755195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073755195 |
| Entity Type | Individual |
| Full Name | LAKEISHA JOYCE BLAIR-WATSON |
| Credential | M.D. |
| Practice Address |
320 Hospital Rd Canton GA 30114-2432 |
| Mailing Address |
1655 Lebanon Rd Lawrenceville GA 30043-5116 |
| Practice Telephone | 7704795535 |
| Practice Fax Number | 7707203294 |
| Mailing Telephone | 7706822024 |
| Mailing Fax Number | 7706822034 |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2018-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 76552 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 4301095380 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1073755195 | 05 |
| Street Address |
320 HOSPITAL RD |
| City | CANTON |
| State | GA |
| Zip Code | 30114-2432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881665248 | Steven M Lobel | Pain Medicine | 320 Hospital Rd, Canton, GA 30114-2432 | 2006-02-01 |
| 1699252387 | Michael C Paine | Registered Nurse | 320 Hospital Rd, Canton, GA 30114-2410 | 2018-07-25 |
| 1457747313 | Nonna R Livits | Family Medicine | 320 Hospital Rd, Canton, GA 30114-2410 | 2015-04-07 |
| 1083041867 | Medical Associates Professional Services, LLC | Chiropractor | 320 Hospital Rd, Canton, GA 30114-2432 | 2013-10-11 |
| 1992147193 | Georgia Urology Pa | Urology | 320 Hospital Rd, Med Assoc of No Ga, Canton, GA 30114-2432 | 2013-07-29 |
| 1407290273 | Jessica Robin Feehan | Nurse Practitioner | 320 Hospital Rd, Canton, GA 30114-2432 | 2013-04-24 |
| 1285909515 | Salvatore Adolfo Bruni | Family Medicine | 320 Hospital Rd, Canton, GA 30114 | 2012-03-20 |
| 1568742237 | Kimberly Finley | Pharmacist | 320 Hospital Rd, Canton, GA 30114-2432 | 2011-08-25 |
| 1902036999 | Janice Denise Reed | Nurse Practitioner | 320 Hospital Rd, Canton, GA 30114-2432 | 2009-07-23 |
| 1508043779 | Avanthi Doppalapudi | Internal Medicine | 320 Hospital Rd, Canton, GA 30114-2432 | 2008-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1396342606 | Kiwi Virtual Health Care Pllc | Family Medicine | 40618 Blythefield Ln, Canton, MI 48188-2251 | 2020-10-08 |
| 1417571142 | K Loor Medical LLC | Family Medicine | 1750 Marietta Hwy Ste 250, Canton, GA 30114-8388 | 2020-05-28 |
| 1336762913 | Favor Family Medical Practice | Family Medicine | 103 Mountain Brook Dr Ste 100, Canton, GA 30115-9078 | 2020-05-18 |
| 1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
| 1073012118 | Mea Primary Care Plus LLC | Family Medicine | 112 Southlake Cir, Canton, MS 39046-5368 | 2018-02-05 |
| 1629592175 | Healthy U Academy, LLC | Family Medicine | 1226 Market Ave N, Canton, OH 44714-2604 | 2017-07-26 |
| 1629508114 | Zeinab M Makki | Family Medicine | 7330 N Canton Center Rd Ste 111, Canton, MI 48187-1538 | 2017-06-15 |
| 1366805210 | Michael Wowk | Family Medicine | 1600 S Canton Center Rd Ste 220, Canton, MI 48188-6276 | 2016-03-29 |
| 1184036832 | Courtney Weaver | Family Medicine | 15 Reinhardt College Pkwy Ste 100, Canton, GA 30114-5259 | 2014-05-29 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.