Healthcare Provider Details

I. General information

NPI: 1346938529
Provider Name (Legal Business Name): MR. JAMES CHRISTOPHER WATSON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 MORNINGSIDE CT
VIRGINIA BEACH VA
23462-3210
US

IV. Provider business mailing address

5741 MORNINGSIDE CT
VIRGINIA BEACH VA
23462-3210
US

V. Phone/Fax

Practice location:
  • Phone: 888-387-1577
  • Fax:
Mailing address:
  • Phone: 888-387-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: