# CAROL L WATSON MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891984274
- **Authorized official:** MS. DEBORAH L. BOUCHARD (PRACTICE MANAGER)
- **Authorized official phone:** (860) 749-4416

## Contact information

- **Practice address:** 140 HAZARD AVENUE, SUITE 107, ENFIELD, CT 06082-4520
- **Practice address phone:** (860) 749-4416
- **Practice address fax:** (860) 749-4506
- **Mailing address:** 140 HAZARD AVE, SUITE 107, ENFIELD, CT 06082-4520
- **Mailing address phone:** (860) 749-4416
- **Mailing address fax:** (860) 749-4506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 042373 | CT | Yes |

## Other

- **Enumeration date:** 10/22/2007
- **Last updated:** 10/22/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00142370 | — | CT |