Individual
KEITH A WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 KAHOE LN, YELLOW SPRINGS, OH 45387-1243
(937) 767-7311
(937) 767-7107
Mailing address
100 KAHOE LN, YELLOW SPRINGS, OH 45387-1243
(937) 767-7311
(937) 767-7107
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-04-3758-W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0496780
—
OH
01
—
160038944
R/R MEDICARE PIN
OH
01
—
311144553026
CARESOURCE PIN
OH
Enumeration date
01/12/2006
Last updated
09/28/2011
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