Provider Demographics
NPI:1518298447
Name:WATSON, JAMES JASON
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JASON
Last Name:WATSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1531
Mailing Address - Country:US
Mailing Address - Phone:740-295-7080
Mailing Address - Fax:740-295-7081
Practice Address - Street 1:353 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1531
Practice Address - Country:US
Practice Address - Phone:740-295-7080
Practice Address - Fax:740-295-7081
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH005876225X00000X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation