Provider Demographics
NPI:1780571786
Name:WATSON, ZACHARY CHANDLER
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:CHANDLER
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 1:1321 18TH AVE S APT 4
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-6627
Mailing Address - Country:US
Mailing Address - Phone:334-322-0604
Mailing Address - Fax:
Practice Address - Street 1:1321 18TH AVE S APT 4
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-6627
Practice Address - Country:US
Practice Address - Phone:334-322-0604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant