Provider Demographics
NPI:1841285681
Name:WATSON, BECKY ANN (MD)
Entity type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:ANN
Last Name:WATSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:ANN
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1500
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-1500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3050
Practice Address - Country:US
Practice Address - Phone:573-302-2764
Practice Address - Fax:573-302-2767
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1F29207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO160026779OtherRAILROAD MEDICARE
MO1841285681Medicaid
MO1841285681Medicaid
MO135570045Medicare PIN
MOMA4964001Medicare PIN
B23406Medicare UPIN