Active NPI
Edwin L Watson, MD
- Family Medicine Physician
- Little Rock, AR
National Provider Identifier
1265547509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C-6480
- Practice address
- 4300 W 7TH St
Little Rock, AR 72205-5446 - Phone
- (501) 257-5060
- Fax
- (501) 257-5056
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C-6480 | AR | Primary |
Addresses
Primary practice location
4300 W 7TH St
Little Rock, AR 72205-5446
Mailing address
12912 Ridgehaven Rd
Little Rock, AR 72211-2210
Phone (501) 225-3562
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-6480 | AR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265547509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12912 RIDGEHAVEN RD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722112210",
"telephone_number": "501-225-3562",
"fax_number": "501-257-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 W 7TH ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722055446",
"telephone_number": "501-257-5060",
"fax_number": "501-257-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "EDWIN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "C-6480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.