Provider Demographics
NPI:1659728087
Name:CLAY WATSON MD PLLC
Entity Type:Organization
Organization Name:CLAY WATSON MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-507-9178
Mailing Address - Street 1:3800 BUCHTEL BLVD
Mailing Address - Street 2:#100984
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-7501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3800 BUCHTEL BLVD
Practice Address - Street 2:#100984
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80250-7501
Practice Address - Country:US
Practice Address - Phone:303-507-9178
Practice Address - Fax:720-932-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46695207R00000X, 207RI0200X
CO46635208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty