Provider Demographics
NPI:1932428661
Name:WATSON, JOEL ANTHONY JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ANTHONY
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6186 S 33RD WEST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1236
Mailing Address - Country:US
Mailing Address - Phone:918-607-8806
Mailing Address - Fax:
Practice Address - Street 1:1705 E 19TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5405
Practice Address - Country:US
Practice Address - Phone:918-872-6880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine