Provider Demographics
NPI:1154453793
Name:WATFORD, JOHN WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name:WATFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4085 TAMIAMI TRL N STE B103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3588
Mailing Address - Country:US
Mailing Address - Phone:239-544-7440
Mailing Address - Fax:239-734-5029
Practice Address - Street 1:4085 TAMIAMI TRL N STE B103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3588
Practice Address - Country:US
Practice Address - Phone:239-744-5440
Practice Address - Fax:239-734-5029
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2010-00899207R00000X
ORMD27322208M00000X
FLME134606208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist