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NPI Code Detail

MEDICARE: KEVIN WATSON PA-C

MEDICARE: KEVIN WATSON PA-C
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
1363A00000XPhysician Assistant15-02340KS
2363A00000XPhysician Assistant083606IA
3363A00000XPhysician Assistant2020008278MO

General Provider Information

NPI Number : 1730635574
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN WATSON PA-C
Provider Business Mailing Address
First Line : 901 E 104TH ST # MS 400
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-4517
Country : US
Telephone Number : 816-932-6433
Fax Number :
Provider Business Practice Location Address
First Line : 4320 WORNALL RD STE 710
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-3246
Country : US
Telephone Number : 816-932-2700
Fax Number : 816-932-2705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2016
Last Update Date : 10/24/2024

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Directions to “ KEVIN WATSON PA-C” Practice Location

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