Provider Demographics
NPI:1043524424
Name:WATTS, JEFFREY L (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:WATTS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3373 COMMERCE PKWY
Mailing Address - Street 2:STE 2
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7130
Mailing Address - Country:US
Mailing Address - Phone:574-214-7504
Mailing Address - Fax:
Practice Address - Street 1:3373 COMMERCE PKWY STE 2
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7130
Practice Address - Country:US
Practice Address - Phone:330-804-9712
Practice Address - Fax:330-804-9811
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH58-003552207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery