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General NPI Number Information
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NPI Number | 1538297213
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Entity Type | Organization
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Legal Business Name | JILL L WATSON MD PC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1401 N 4TH AVE SUITE 100
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City | PURCELL
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State | OK
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Zip | 73080-1806
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Country | US
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Telephone | 405-527-1124
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Fax | 405-527-0567
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Provider Business Mailing Address
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Address Line | 1401 N 4TH AVE SUITE 100
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City | PURCELL
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State | OK
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Zip | 73080-1806
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Country | US
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Telephone | 405-527-1124
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Fax | 405-527-0567
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Authorized Official
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Title or Position | PRESIDEN T
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Name | DR. JILL L WATSON
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Credential | MD PC
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Telephone | 405-527-1124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20263
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License Number State | OK
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