Provider Demographics
NPI:1114769593
Name:WATSON, ALBERT III
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:WATSON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 RAKEFORD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6151
Mailing Address - Country:US
Mailing Address - Phone:614-551-5108
Mailing Address - Fax:
Practice Address - Street 1:987 E ASH ST STE A02
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4133
Practice Address - Country:US
Practice Address - Phone:937-615-6015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator