Provider Demographics
NPI:1134217649
Name:WATTS, DONALD F (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:F
Last Name:WATTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3955 HARRISON BLVD
Mailing Address - Street 2:L-1
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2313
Mailing Address - Country:US
Mailing Address - Phone:801-621-1701
Mailing Address - Fax:801-393-9411
Practice Address - Street 1:3955 HARRISON BLVD
Practice Address - Street 2:L-1
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2313
Practice Address - Country:US
Practice Address - Phone:801-621-1701
Practice Address - Fax:801-393-9411
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT164699-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics