Provider Demographics
NPI:1851484778
Name:BARTON, WATTS, & PERRY PSC
Entity Type:Organization
Organization Name:BARTON, WATTS, & PERRY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-528-2124
Mailing Address - Street 1:121 BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-1702
Mailing Address - Country:US
Mailing Address - Phone:606-528-2124
Mailing Address - Fax:606-528-8272
Practice Address - Street 1:121 BISHOP ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1702
Practice Address - Country:US
Practice Address - Phone:606-528-2124
Practice Address - Fax:606-528-8272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207Q00000X, 363L00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2716Medicare ID - Type Unspecified