Stanley Jack Watson Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301040333 Issued in MI

Practice address

205 Zina Pitcher PL
Mbni
Ann Arbor, MI 48109-0720

Phone

(734) 763-3725

Fax

(734) 647-4130

NPI assigned

Apr 9, 2008

Last updated

Apr 9, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1154594265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ZINA PITCHER PL",
            "address_2": "MBNI",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090720",
            "telephone_number": "734-763-3725",
            "fax_number": "734-647-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ZINA PITCHER PL",
            "address_2": "MBNI",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090720",
            "telephone_number": "734-763-3725",
            "fax_number": "734-647-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "STANLEY",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301040333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "43010440333",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Suzette Watson, AUD
• Kaylena Kenae-Marie Watson
• Matthew Livingston Watson, M.D.
• Michael Edmund Watson, MD
• Neelege Watson
• Abigail Watt
• Tessa Watt, MD
• Brook Watts, MD
• Cailin Watts, PT, DPT
• Fawn Renee Watts, NP

• Psychiatry Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.