Provider Demographics
NPI:1699510875
Name:WATSON INTEGRATED FAMILY MEDICINE
Entity type:Organization
Organization Name:WATSON INTEGRATED FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:INTEGRATED FAMILY
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:802-318-4768
Mailing Address - Street 1:2000 MEMORIAL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-8320
Mailing Address - Country:US
Mailing Address - Phone:802-318-4768
Mailing Address - Fax:802-424-1163
Practice Address - Street 1:2000 MEMORIAL DR STE 4
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-8320
Practice Address - Country:US
Practice Address - Phone:802-318-4768
Practice Address - Fax:802-424-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-28
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty