Individual
BRENT E WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6822
(304) 927-6807
Mailing address
200 HOSPITAL DR, SPENCER, WV 25276-1050
(304) 927-6822
(304) 927-6807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20497
WV
208000000X
Pediatrics Physician
20497
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1805978000
—
WV
01
—
7339671
MEDICARE
WV
Enumeration date
04/03/2006
Last updated
10/27/2010
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