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General NPI Number Information
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NPI Number | 1467413617
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Entity Type | Organization
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Legal Business Name | WATSON DRY EYE CENTER, PA
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 11081 WAKE FOREST DRIVE SUITE112
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City | RALEIGH
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State | NC
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Zip | 27614-7655
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Country | US
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Telephone | 252-231-0424
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Fax | 252-231-0580
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Provider Business Mailing Address
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Address Line | 512 SHADY CIRCLE DRIVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27803-1715
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Country | US
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Telephone | 252-231-0424
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Fax | 252-231-0580
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN AUSTIN WATSON
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Credential | M.D.
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Telephone | 252-231-0424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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