Provider Demographics
NPI:1013927250
Name:WATT, JOHN H (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:WATT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10837 STABLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-8846
Mailing Address - Country:US
Mailing Address - Phone:317-894-8581
Mailing Address - Fax:317-894-8581
Practice Address - Street 1:1002 W 10TH ST
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2879
Practice Address - Country:US
Practice Address - Phone:317-630-6708
Practice Address - Fax:317-630-8617
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26011205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist