Provider Demographics
NPI:1336127950
Name:WATTON, STEVE D (PA C)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:D
Last Name:WATTON
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Gender:M
Credentials:PA C
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Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:505 SO PARK ST PARK STREET MEDICAL CLINIC
Mailing Address - City:GENOA
Mailing Address - State:NE
Mailing Address - Zip Code:68640-0310
Mailing Address - Country:US
Mailing Address - Phone:402-993-2206
Mailing Address - Fax:402-993-2595
Practice Address - Street 1:505 S PARK ST
Practice Address - Street 2:PARK STREET MEDICAL CLINIC
Practice Address - City:GENOA
Practice Address - State:NE
Practice Address - Zip Code:68640-3036
Practice Address - Country:US
Practice Address - Phone:402-993-2206
Practice Address - Fax:402-993-2595
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NE519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant