Healthcare Provider Details

I. General information

NPI: 1144545740
Provider Name (Legal Business Name): RICHARD WATSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 PINE TREE CIR STE 120
VESTAVIA AL
35243-2380
US

IV. Provider business mailing address

4505 PINE TREE CIR STE 120
VESTAVIA AL
35243-2380
US

V. Phone/Fax

Practice location:
  • Phone: 205-637-7123
  • Fax:
Mailing address:
  • Phone: 205-637-7123
  • Fax: 205-831-2729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD15306
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD.39133
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number266923
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD.39133
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: