Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OS010394L | PA |
NPI | 1013930692 |
---|---|
Provider Name | Dr. Joseph R Watson |
First Address | Wyomissing, PA 19610-1986 |
Second Address | Wyomissing, PA 19610-1986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 24/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101334540001 | (05) | PA |
122621 | (02) | PA |