Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR0052197 | CO |
N | 207X00000X | Orthopaedic Surgeon | MD35687 | TN |
Y | 207XS0106X | Orthopaedic Hand Surgeon | DR0052197 | CO |
N | 207XS0106X | Orthopaedic Hand Surgeon | MD35687 | TN |
NPI | 1336236447 |
---|---|
Provider Name | Jeffry T Watson |
First Address | Colorado Springs, CO 80920-7835 |
Second Address | Colorado Springs, CO 80920-7835 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 05/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H18782 | (02) |