Ben Gervas Watson
Sports Medicine Doctor
840 S Fairmont Ave Suite 9
Lodi
, California 95240-5105
Ben Gervas Watson
Sports Medicine Doctor
840 S Fairmont Ave Suite 9
Lodi
, California 95240-5105
(209) 333-1751
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Ben Gervas Watson
- 840 S Fairmont Ave Ste. 9
- Lodi, CA
- Zip : 95240-5105
- Phone : (209) 333-1751
Second Address
- Ben Gervas Watson
- 840 S Fairmont Ave Suite 9
- Lodi, CA
- Zip : 95240-5105
- Phone : (209) 333-1751
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | A40293 | CA |
National Provider Identifier
| NPI | 1467500181 |
|---|---|
| Provider Name | Ben Gervas Watson |
| First Address | Lodi, CA 95240-5105 |
| Second Address | Lodi, CA 95240-5105 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/01/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.