Watters, Roger D

Watters, Roger D is an individual health care provider with primary practice located at 117 E Clark St , Harrisburg IL 62946-2702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Watters, Roger D can be contacted via phone (618) 252-8625.

Contact Information

Primary practice address
117 E Clark St Harrisburg IL 62946-2702
Phone: (618) 252-8625
Fax: (618) 252-2540
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036062428 Illinois

Profile Details

NPI number 1356321343
LBN Legal business name Watters, Roger D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Feb 2nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1356321343 NPPES
Illinois MEDICAID 036062428.

Popular Providers