Provider Demographics
NPI:1932218716
Name:WATSON, HAROLD KIRK (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:KIRK
Last Name:WATSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:195 EASTERN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1208
Mailing Address - Country:US
Mailing Address - Phone:860-527-7161
Mailing Address - Fax:860-251-6128
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 816
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-527-7161
Practice Address - Fax:860-652-8410
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT010692207XS0106X
ME008232207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001106921Medicaid
CT200000080Medicare PIN
CT001106921Medicaid