Individual
DR. CHARLES KEVIN WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 S MAIN ST, ROGERSVILLE, MO 65742-9357
(417) 753-9404
(417) 753-9137
Mailing address
101 S MAIN ST, ROGERSVILLE, MO 65742-9357
(417) 753-9404
(417) 753-9137
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
R2D59
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134124324
—
MO
05
—
241858372
—
MO
01
—
P00003782
RR MEDICARE
—
Enumeration date
06/15/2005
Last updated
08/19/2022
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