Physician Compare National (NPI:1326025743)

HEALTHCARE PROVIDER: KEVIN J WATT M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1326025743
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123128600
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070712000637
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WATT
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Middle Name	JEROME
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PLASTIC AND RECONSTRUCTIVE SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PLASTIC AND RECONSTRUCTIVE SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	6310 N MAIN ST
	Group Practice or individual's line 1 address
City	DAYTON
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	454153155
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9372742733
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y