Individual
MR. ERIC MICHAEL WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8521
(618) 288-5711
(618) 288-4088
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007055
IL
Other
Enumeration date
01/08/2019
Last updated
04/12/2021
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