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Individual

MR. STEVEN J WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
108 SMART PLACE, SUITE A, SLIDELL, LA 70458
(985) 649-0002
(985) 649-0034
Mailing address
108 SMART PLACE, SUITE A, SLIDELL, LA 70458
(985) 649-0002
(985) 649-0034

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD021R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00015683
MEDICAID
MS
05
1318418
LA
01
CN3638
RAILROAD MEDICARE
LA
01
CN3639
RAILROAD MEDICARE
MS
01
CN3640
RAILROAD MEDICARE
LA
Enumeration date
05/23/2006
Last updated
04/01/2008
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