MEDICARE: DR. NOEL J 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	207Q00000X	Family Medicine Physician	35-03-3754-W	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	080191720	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	421534506	OTHER	OH	CIGNA
2	1007306	OTHER	OH	AETNA
3	34001319	OTHER	OH	MECICAL LICENSE
4	421534506096	OTHER	OH	CARESOURCE
5	000000227850	OTHER	OH	BCBS-OH
6	35033754	OTHER	OH	MEDICAL LICENSE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942205109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOEL J WATSON M.D.

Provider Business Mailing Address
First Line	:	2912 SPRINGBORO W
Second Line	:	STE 201
City	:	DAYTON
State	:	OH
Zip	:	45439-1674
Country	:	US
Telephone Number	:	937-297-8996
Fax Number	:	937-855-7279

Provider Business Practice Location Address
First Line	:	1217 W MARKET ST
Second Line	:
City	:	GERMANTOWN
State	:	OH
Zip	:	45327-1715
Country	:	US
Telephone Number	:	937-855-7275
Fax Number	:	937-855-7279

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	01/22/2021

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Directions to “ DR. NOEL J WATSON M.D.” Practice Location

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