MR. Wallace Carlisle Watson JR., PA

NPI #1073554150 in Cuba, New York

Provider Information

NPI Number: 1073554150
Entity Type: Individual
Name: MR. Wallace Carlisle Watson JR., PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 9, 2006
Last Updated: May 28, 2013

Practice Location

Address: 21 E MAIN ST
City: Cuba
State: New York
ZIP Code: 14727-1205
Phone: (585) 968-4357

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X
Physician Assistant	363A00000X	Primary

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