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General NPI Number Information
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NPI Number | 1275536138
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Entity Type | Individual
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Provider Name | WILLIAM J. WATERHOUSE MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 2478 PATTERSON RD # 7
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City | GRAND JCT
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State | CO
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Zip | 81505-3605
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Country | US
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Telephone | 970-255-7065
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Fax | 970-255-7076
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Provider Business Mailing Address
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Address Line | 2478 PATTERSON RD # 7
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City | GRAND JCT
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State | CO
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Zip | 81505-3605
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Country | US
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Telephone | 970-255-7065
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Fax | 970-255-7076
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 33513
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License Number State | CO
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