Individual
TYLER WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
616 E HIGH ST, JEFFERSON CITY, MO 65101-3219
(573) 340-5121
Mailing address
4008 GREENBRIER DR, JEFFERSON CITY, MO 65109-8717
(573) 340-5121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2021024093
MO
207Q00000X
Family Medicine Physician
Primary
2022041048
MO
Other
Enumeration date
08/30/2018
Last updated
02/24/2026
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