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General NPI Number Information
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NPI Number | 1164750337
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Entity Type | Organization
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Legal Business Name | WILLIAM A. WATSON O.D. P.C.
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Dates
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Enumeration Date | 11/30/2009
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 1025 W STEARNS RD
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City | BARTLETT
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State | IL
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Zip | 60103-4509
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Country | US
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Telephone | 630-736-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 1 POINT O WOODS CT
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-5928
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Country | US
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Telephone | 847-854-2433
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST, PRESIDENT
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Name | DR. WILLIAM A WATSON
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Credential | O.D.
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Telephone | 847-800-7660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 46009165
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License Number State | IL
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