| Doctor Name: | MR. RONALD DAVID WATSON |
| NPI Number: | 1225214562 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA9101226 |
| Business Practice Address: | 300 Long Ave Port St Joe, FL - 324561706 |
| Business Phone Number: | 8502298288 |
| Business Fax Number: | 8502297030 |
| Mailing Address: | 300 Long Ave, PORT ST JOE |
| State: | FL |
| Postal Code: | 324561706 |
| Phone Number: | 8502298288 |
| Fax Number: | 8502297030 |
| NPI Enumeration Date: | 01/17/2008 |
| NPI Last Update Date: | 10/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9101226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |