Provider Demographics
NPI:1952905606
Name:WATSON, DANIEL ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALLEN
Last Name:WATSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2704 OAKLAWN BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-4935
Mailing Address - Country:US
Mailing Address - Phone:804-458-7204
Mailing Address - Fax:804-381-5177
Practice Address - Street 1:2704 OAKLAWN BLVD
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-4935
Practice Address - Country:US
Practice Address - Phone:804-458-7204
Practice Address - Fax:804-381-5177
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist