Organization
EYE PHYSICIANS & FACIAL PLASTIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J WATT MD (OWNER)
(937) 274-2733
Entity
Organization
Contact information
Practice address
5900 N MAIN ST, DAYTON, OH 45415-3150
(937) 274-2733
(937) 274-2737
Mailing address
PO BOX 1314, DAYTON, OH 45401-1314
(937) 274-2733
(937) 274-2737
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
35-071393W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2111324
—
OH
Enumeration date
05/03/2016
Last updated
05/03/2016
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