Mr Wallace Carlisle Watson Jr, PA is a
Physician Assistant physician based in Cuba, New York. Mr Wallace Carlisle Watson Jr is licensed to practice in New York (license number 001255) and his current practice location is 21 E Main St, Cuba, New York. He can be reached at his office (for appointments etc.) via phone at
(585) 968-4357.
NPI number for Mr Wallace Carlisle Watson Jr is 1073554150 and his current mailing address is 2211 W State St, Suite 121, Olean, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1073554150.
Physician's Profile
| Full Name | Mr Wallace Carlisle Watson Jr |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
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| Location | 21 E Main St, Cuba, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1073554150
- Provider Enumeration Date: 06/09/2006
- Last Update Date: 05/28/2013
Medical Identifiers
Medical identifiers for Mr Wallace Carlisle Watson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073554150 | NPI | - | NPPES |
| 0490352 | Other | NY | IHA |
| 00010257702 | Other | | UNIVERA |
| 407113852 | Other | | RAILROAD MEDICARE |
| 000508499002 | Other | NY | BCWNY |
| 2598491 | Other | | GHI |
| 01531593 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 0012551 (New York) | Secondary |
| 363A00000X | Physician Assistant | 001255 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Wallace Carlisle Watson Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Wallace Carlisle Watson Jr, PA
2211 W State St, Suite 121,
Olean, NY 14760-1951
Ph: (716) 372-2708 | Mr Wallace Carlisle Watson Jr, PA
21 E Main St,
Cuba, NY 14727-1205
Ph: (585) 968-4357 |
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