Healthcare Provider Details

I. General information

NPI: 1932218716
Provider Name (Legal Business Name): HAROLD KIRK WATSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST SUITE 816
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

195 EASTERN BLVD SUITE 200
GLASTONBURY CT
06033-1208
US

V. Phone/Fax

Practice location:
  • Phone: 860-527-7161
  • Fax: 860-652-8410
Mailing address:
  • Phone: 860-527-7161
  • Fax: 860-251-6128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number010692
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number008232
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: