Individual
DR. JEFFREY W. WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2534 W 15TH AVE, EMPORIA, KS 66801-6102
(620) 343-6011
(620) 343-6353
Mailing address
2534 W 15TH AVE, EMPORIA, KS 66801-6102
(620) 343-6011
(620) 343-6353
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12-00179
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006713
BLUE CROSS BLUE SHIELD OF
KS
05
—
100094290A
—
KS
05
—
100094290C
—
KS
01
—
480000830
PALMETTO GBA-RR MEDICARE
KS
Enumeration date
08/30/2006
Last updated
05/07/2008
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