Dr. Charles Kevin Watt
Family Doctor - Geriatric Medicine
101 S Main St
Rogersville
, Missouri 65742-9357
Dr. Charles Kevin Watt
Family Doctor - Geriatric Medicine
101 S Main St
Rogersville
, Missouri 65742-9357
(417) 753-9137
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Charles Kevin Watt
- 101 S Main St
- Rogersville, MO
- Zip : 65742-9357
- Fax : (417) 753-9137
- Phone : (417) 753-9404
Second Address
- Dr. Charles Kevin Watt
- 101 S Main St
- Rogersville, MO
- Zip : 65742-9357
- Fax : (417) 753-9137
- Phone : (417) 753-9404
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | R2D59 | MO |
National Provider Identifier
| NPI | 1134124324 |
|---|---|
| Provider Name | Dr. Charles Kevin Watt |
| First Address | Rogersville, MO 65742-9357 |
| Second Address | Rogersville, MO 65742-9357 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/06/2005 |
| Last Update Date | 17/06/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1134124324 | (05) | MO |
| 241858372 | (05) | MO |
| D41550 | (02) | |
| P00003782 | RR MEDICARE (01) |
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.