Provider Demographics
NPI:1487335121
Name:WATSON FED COMP SPECIALIST INC
Entity type:Organization
Organization Name:WATSON FED COMP SPECIALIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:405-931-2602
Mailing Address - Street 1:1016 SOUTH DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5209
Mailing Address - Country:US
Mailing Address - Phone:405-931-2602
Mailing Address - Fax:405-931-3186
Practice Address - Street 1:1016 SOUTH DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5209
Practice Address - Country:US
Practice Address - Phone:405-931-2602
Practice Address - Fax:405-931-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty