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General NPI Number Information
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NPI Number | 1528089786
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Entity Type | Organization
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Legal Business Name | STEPHEN D. WATSON, M.D., PHD., INC.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2816 W 1ST ST
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City | SPRINGFIELD
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State | OH
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Zip | 45504-4264
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Country | US
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Telephone | 937-323-3900
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Fax | 937-398-0329
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Provider Business Mailing Address
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Address Line | 2816 W 1ST ST
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City | SPRINGFIELD
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State | OH
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Zip | 45504-4264
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Country | US
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Telephone | 937-323-3900
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Fax | 937-398-0329
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Authorized Official
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Title or Position | BILLING / OFFICE MANAGER
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Name | MS. JULIE L. LEDBETTER
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Credential | CMAA, CPC
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Telephone | 937-323-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35063329W
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License Number State | OH
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