Healthcare Provider Details

I. General information

NPI: 1467432906
Provider Name (Legal Business Name): ROBERT DENNIS WATSON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S UNIVERSITY BLVD STE B
MOBILE AL
36609-2923
US

IV. Provider business mailing address

PO BOX 851401
MOBILE AL
36685-1401
US

V. Phone/Fax

Practice location:
  • Phone: 813-545-9924
  • Fax: 866-773-3520
Mailing address:
  • Phone: 251-610-6379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number00025436
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number25436
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: