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General NPI Number Information
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NPI Number | 1023007507
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Entity Type | Individual
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Provider Name | WILLIAM J. WATSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 1035 PEACH ST SUITE 301
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2700
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Country | US
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Telephone | 805-545-5665
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Fax | 805-544-6477
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Provider Business Mailing Address
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Address Line | 1035 PEACH ST SUITE 301
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2700
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Country | US
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Telephone | 805-545-5665
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Fax | 805-544-6477
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G42368
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License Number State | CA
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