Provider Demographics
NPI:1962589200
Name:DR. STEVE J. WATSON &DR. WILLIAM H. DABDOUB, APMC
Entity type:Organization
Organization Name:DR. STEVE J. WATSON &DR. WILLIAM H. DABDOUB, APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-649-0002
Mailing Address - Street 1:108 SMART PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2040
Mailing Address - Country:US
Mailing Address - Phone:985-649-0002
Mailing Address - Fax:985-649-0034
Practice Address - Street 1:108 SMART PL
Practice Address - Street 2:SUITE A
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2040
Practice Address - Country:US
Practice Address - Phone:985-649-0002
Practice Address - Fax:985-649-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD024R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1318418Medicaid
LACN3638OtherRAILROAD MEDICARE
MSCN3639OtherRAILROAD MEDICARE
LACN3640OtherRAILROAD MEDICARE
LA1318400Medicaid
LACN3638OtherRAILROAD MEDICARE
LA1318418Medicaid
MS0533030001Medicare NSC
LAT19698Medicare UPIN
LAT19728Medicare UPIN
LA5C213Medicare PIN