Provider Demographics
NPI:1578619490
Name:WATT, HELEN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:ELIZABETH
Last Name:WATT
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:PO BOX 28876
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0164
Mailing Address - Country:US
Mailing Address - Phone:480-368-9608
Mailing Address - Fax:480-686-9007
Practice Address - Street 1:7331 E OSBORN DR STE 240
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6422
Practice Address - Country:US
Practice Address - Phone:480-368-9608
Practice Address - Fax:480-686-9007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22016133N00000X, 208D00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ158619Medicaid
AZZ114384Medicare PIN
AZ158619Medicaid