Individual
DR. RICHARD LEE WATSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1124 W 21ST ST, ANDOVER, KS 67002-5500
(620) 242-7865
Mailing address
5331 N HIGHLAND ST, RUSTON, WA 98407-3210
(620) 242-7865
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21486
KS
207Q00000X
Family Medicine Physician
B21486
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100208970A
—
KS
Enumeration date
11/21/2006
Last updated
02/11/2022
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