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General NPI Number Information
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NPI Number | 1689965741
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Entity Type | Individual
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Provider Name | JOHN SKELLY WATSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 803 S JACKSON AVE SUITE 130
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City | TULSA
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State | OK
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Zip | 74127-9010
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Country | US
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Telephone | 918-596-7075
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Fax | 918-596-7077
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Provider Business Mailing Address
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Address Line | 1820 S LYNN LANE RD
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City | TULSA
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State | OK
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Zip | 74108-6300
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Country | US
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Telephone | 918-633-1967
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Fax | 918-437-0072
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 8871
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License Number State | OK
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