Individual provider Active NPI

Robert A Watson II, MD

  • Family Medicine Physician
  • El Dorado, AR
National Provider Identifier
1417060286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E1050 Issued in AR
Practice address
3108 North West Avenue
El Dorado, AR 71730
Phone
(870) 863-9020
Fax
(870) 863-7209
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E1050 AR Primary

Addresses

Primary practice location

3108 North West Avenue
El Dorado, AR 71730

Mailing address

3108 North West Avenue
El Dorado, AR 71730
Phone (870) 863-9020

Other identifiers 1

IdentifierTypeStateIssuer
130131001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000053 AR Practitioner - Family Practice 3375509540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care of Southern Arkansas, LTDGroup PAC ID 3375702038, 2 clinicians

Practice addresses (Care Compare)

11001 Executive Ctr Dr
Suite 200
Little Rock, AR 72211-4393

3108 N W Ave
El Dorado, AR 71730-2731
Phone (870) 863-9020

Hospital & facility affiliations

  • South Arkansas Home Health Home health agency, El Dorado, AR, CCN 047021
  • South Arkansas Regional Hospital LLC Hospital, El Dorado, AR, CCN 040088
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114
  • Ouachita County Medical Center Hospital, Camden, AR, CCN 040050
  • Ashley County Medical Center Hospital, Crossett, AR, CCN 041323

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions18
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E1050ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care of Southern Arkansas, LTD Family Medicine CurrentSince Nov 28, 2011 Accepting new patients
South Arkansas Physician Services LLC Family Medicine Past Accepting new patients

Locations

3108 N West Ave
El Dorado, AR 71730
Phone (870) 863-9020

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417060286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 NORTH WEST AVENUE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "71730",
            "telephone_number": "870-863-9020",
            "fax_number": "870-863-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 NORTH WEST AVENUE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "71730",
            "telephone_number": "870-863-9020",
            "fax_number": "870-863-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130131001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.