Provider Demographics
NPI:1801248562
Name:WATSON, TOREY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TOREY
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SAINT FRANCOIS PLZ
Mailing Address - Street 2:
Mailing Address - City:LEADINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63601-4454
Mailing Address - Country:US
Mailing Address - Phone:573-431-5040
Mailing Address - Fax:
Practice Address - Street 1:113 SAINT FRANCOIS PLZ
Practice Address - Street 2:
Practice Address - City:LEADINGTON
Practice Address - State:MO
Practice Address - Zip Code:63601-4454
Practice Address - Country:US
Practice Address - Phone:573-431-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016023696163WD0400X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator