Individual
DR. ALEX BENTON WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2003025568
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
M-11086
ID
207V00000X
Obstetrics & Gynecology Physician
MD60171764
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0267798
LABOR & INDUSTRIES
WA
01
—
1780659920
REGENCE BLUE SHIELD
ID
05
—
1780659920
—
ID
05
—
2009820
—
WA
01
—
78464
BC/ID
ID
01
—
P00884051
RR MEDICARE
IL
Enumeration date
02/21/2006
Last updated
03/07/2016
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