Individual
DR. RANDALL L. WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1575 W 7000 S, WEST JORDAN, UT 84084-3431
(801) 569-9133
(801) 569-9103
Mailing address
1575 W 7000 S, WEST JORDAN, UT 84084-3431
(801) 569-9133
(801) 569-9103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
175699-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174707517
GROUP / CORP NPI
UT
01
—
1952341000
NPI
UT
Enumeration date
06/07/2006
Last updated
06/26/2012
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