Organization
WATERTOWN EAR NOSE AND THROAT GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAXTON L HILLERMAN MD (PRESIDENT)
(315) 788-1751
Entity
Organization
Contact information
Practice address
826 WASHINGTON ST, SUITE 204, WATERTOWN, NY 13601-4064
(315) 788-1751
(315) 788-9021
Mailing address
826 WASHINGTON ST, SUITE 204, WATERTOWN, NY 13601-4064
(315) 788-1751
(315) 788-9021
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00458053
—
NY
Enumeration date
09/29/2006
Last updated
08/22/2020
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