Provider Demographics
NPI:1851497507
Name:WATSON, RONALD CARL (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CARL
Last Name:WATSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 COOPER FOSTER PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001
Mailing Address - Country:US
Mailing Address - Phone:440-960-2824
Mailing Address - Fax:440-960-2923
Practice Address - Street 1:1815 COOPER FOSTER PARK ROAD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001
Practice Address - Country:US
Practice Address - Phone:440-960-2824
Practice Address - Fax:440-960-2923
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0413971Medicare ID - Type Unspecified