Dr Mark Raymond Watson PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4076 Issued in FL

Legal business name

DR MARK RAYMOND WATSON PA

Practice address

3175 Cheney Hwy
Titusville, FL 32780-5979

Phone

(321) 383-8040

Fax

(321) 267-1544

NPI assigned

Sep 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mark Raymond Watson, OD

Title

President

Phone

(321) 383-8040

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1730430877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3437 DEER OAK CIR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327668111",
            "telephone_number": "904-589-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 CHENEY HWY",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805979",
            "telephone_number": "321-383-8040",
            "fax_number": "321-267-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK RAYMOND WATSON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-383-8040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Titusville, FL
• Providers in Titusville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.