Provider Demographics
NPI:1184665887
Name:WATTS, BELINDA J (MD)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:J
Last Name:WATTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:STE 130 PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 W OAK ST
Practice Address - Street 2:STE 104
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-3835
Practice Address - Country:US
Practice Address - Phone:317-873-8910
Practice Address - Fax:317-873-8821
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100350760Medicaid
INF46371Medicare UPIN
IN100350760Medicaid
INP00844434Medicare PIN
INM400015255Medicare PIN