MEDICARE: DR. JERRY RAY WATSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	D7497	TX

General Provider Information

NPI Number	:	1316902976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY RAY WATSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 771164
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80477-1164
Country	:	US
Telephone Number	:	970-871-1492
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 SUNDANCE CT
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-3058
Country	:	US
Telephone Number	:	970-871-1492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	07/08/2007

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