Provider Demographics
NPI:1861983769
Name:WATSON, ROBERT JAMES V (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:WATSON
Suffix:V
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 45TH STREET
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-4200
Mailing Address - Country:US
Mailing Address - Phone:219-227-4033
Mailing Address - Fax:708-931-0119
Practice Address - Street 1:2022 45TH STREET
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-4200
Practice Address - Country:US
Practice Address - Phone:219-227-4033
Practice Address - Fax:708-931-0119
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor