Provider Demographics
NPI:1144201146
Name:WATSON, RACHEL C (OD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:WATSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7465 COVENTRY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8608
Mailing Address - Country:US
Mailing Address - Phone:614-595-5027
Mailing Address - Fax:614-451-8642
Practice Address - Street 1:2250 N BANK DR
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-5420
Practice Address - Country:US
Practice Address - Phone:614-451-7550
Practice Address - Fax:614-451-8642
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.005347152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCAQHOther11313744
OH2421427Medicaid
OHCAQHOther11313744
OHWA4114911Medicare ID - Type Unspecified