John O Watson
Pain Medicine
1301 S Koke Mill Rd
Springfield
, Illinois 62711-9252
John O Watson
Pain Medicine
1301 S Koke Mill Rd
Springfield
, Illinois 62711-9252
(217) 547-9247
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About
Features
Specialties
- Pain Medicine
Languages spoken
- English
Location
First Address
- John O Watson
- Po Box 9469
- Springfield, IL
- Zip : 62791-9469
- Fax : (217) 547-9247
- Phone : (217) 547-9100
Second Address
- John O Watson
- 1301 S Koke Mill Rd
- Springfield, IL
- Zip : 62711-9252
- Fax : (217) 547-9247
- Phone : (217) 547-9100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081P2900X | Pain Medicine | 036119109 | IL |
National Provider Identifier
| NPI | 1396770087 |
|---|---|
| Provider Name | John O Watson |
| First Address | Springfield, IL 62791-9469 |
| Second Address | Springfield, IL 62711-9252 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2006 |
| Last Update Date | 13/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036119109 | (05) | IL |
| P00608201 | RR MEDICARE (01) | IL |
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.