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Individual

JUSTIN J WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2119 REGENT ST, MADISON, WI 53726-3941
(360) 305-4988
Mailing address
2119 REGENT ST, MADISON, WI 53726-3941
(360) 305-4988

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
73952
WI
207RC0000X
Cardiovascular Disease Physician
MED-PHYS-LIC-127761
MT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
127761
MT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
73952
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100180924
WI
Enumeration date
04/11/2012
Last updated
11/02/2023
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