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DR. RANDY GREGG WATSKY OD

Eye and Vision Services Providers Optometrist

Provider NPI: 1497843569

Provider Information:
DR. RANDY GREGG WATSKY OD
Gender: M
Sole Proprietor

Practice Location:
8709 W GRAND RIVER AVE SUITE A BRIGHTON, MI 48116-2923 US
Tel: 810-220-4499  Fax: 810-220-4433

Business Mailing Address:
8709 W GRAND RIVER AVE SUITE A BRIGHTON, MI 48116-2923 US
Tel: 810-220-4499  Fax: 810-220-4433

NPI Information:
NPI: 1497843569
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
MI4901003655
N152WC0802XEye and Vision Services Providers
Optometrist
MI4901003655
N152WX0102XEye and Vision Services Providers
Optometrist
MI4901003655

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 152W00000X

Type:

Classification:



Definition:



MEDICAL JOBS MI - Page 1

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