Individual
DR. THOMAS JACK WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3577 W 13 MILE RD STE 202A, ROYAL OAK, MI 48073-6710
(248) 551-0669
(248) 551-0058
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
204470
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01687549
—
NY
Enumeration date
06/29/2006
Last updated
05/20/2021
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