MEDICARE: STEVEN E. WATSON, D.O.

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	207Q00000X	Family Medicine Physician	1983	OK

General Provider Information

NPI Number	:	1609064351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN E. WATSON, D.O.

Provider Business Mailing Address
First Line	:	6600 S WESTERN AVE
Second Line	:	SUITE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-1700
Country	:	US
Telephone Number	:	405-631-9091
Fax Number	:	405-631-9990

Provider Business Practice Location Address
First Line	:	6600 S WESTERN AVE
Second Line	:	SUITE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-1700
Country	:	US
Telephone Number	:	405-631-9091
Fax Number	:	405-631-9990

Authorized Official
Title or Position	:	OFFICE ADMINISTRATOR
Name	:	MR. JAMES EDWARD WILBANKS
Credential	:
Telephone Number	:	405-631-9091

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/09/2007

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