Individual
CLYDE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5900 LONG MEADOW DR, MIDDLETOWN, OH 45005-9687
(513) 420-3773
(513) 727-2539
Mailing address
5900 LONG MEADOW DR, MIDDLETOWN, OH 45005-9687
(513) 420-3773
(513) 727-2539
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35.038821
OH
207P00000X
Emergency Medicine Physician
35038821
NC
207Q00000X
Family Medicine Physician
Primary
35.038821
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000032022
BCBS
—
05
—
0296595
—
OH
01
—
P00193943
RR MCR
—
Enumeration date
08/18/2006
Last updated
08/12/2015
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