Provider Demographics
NPI:1609919976
Name:WATTS, JASON TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:TODD
Last Name:WATTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8228 PARK MEADOWS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2761
Mailing Address - Country:US
Mailing Address - Phone:303-790-7766
Mailing Address - Fax:303-790-9486
Practice Address - Street 1:8228 PARK MEADOWS DR
Practice Address - Street 2:SUITE A
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2761
Practice Address - Country:US
Practice Address - Phone:303-790-7766
Practice Address - Fax:303-790-9486
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO486128Medicare ID - Type UnspecifiedPEAK CHIROPRACTIC
COU93930Medicare UPIN
CO486148Medicare ID - Type UnspecifiedJASON WATTS, DC