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General NPI Number Information
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NPI Number | 1861497695
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Entity Type | Individual
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Provider Name | CHARLES C WATSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 1989 MIAMISBURG CENTERVILLE RD STE 204
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City | DAYTON
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State | OH
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Zip | 45459-3858
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Country | US
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Telephone | 937-401-6822
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Fax | 937-401-6910
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Provider Business Mailing Address
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Address Line | 1989 MIAMISBURG CENTERVILLE RD STE 204
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City | DAYTON
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State | OH
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Zip | 45459-3858
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Country | US
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Telephone | 937-401-6822
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Fax | 937-401-6910
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34-00-3378-W
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License Number State | OH
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