Individual
DR. DOUGLAS R WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
301 W MADISON ST, PONTIAC, IL 61764-1705
(815) 844-2015
(815) 844-4918
Mailing address
301 W MADISON ST, PONTIAC, IL 61764-1705
(815) 844-2015
(815) 844-4918
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007842
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007842
—
IL
Enumeration date
10/20/2005
Last updated
10/20/2009
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