MEDICARE: DR. STEPHEN D. WATSON M.D., PHD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	35-06-3329	OH
2	208VP0014X	Interventional Pain Medicine Physician	ME105674	FL
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	93018	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265625321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN D. WATSON M.D., PHD.

Provider Business Mailing Address
First Line	:	10903 SHELDON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-4702
Country	:	US
Telephone Number	:	813-920-3022
Fax Number	:	813-920-7666

Provider Business Practice Location Address
First Line	:	201A RICHARD ST.
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29640
Country	:	US
Telephone Number	:	864-343-4190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	10/04/2024

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Directions to “ DR. STEPHEN D. WATSON M.D., PHD.” Practice Location

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