Provider Demographics
NPI:1700087897
Name:WATT, JAMES F (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:WATT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 MAR WALT DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6639
Mailing Address - Country:US
Mailing Address - Phone:850-863-2153
Mailing Address - Fax:850-863-8085
Practice Address - Street 1:1034 MAR WALT DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6639
Practice Address - Country:US
Practice Address - Phone:850-863-2153
Practice Address - Fax:850-863-8085
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11237207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherAETNA
FL14E41OtherBC/BS
FL2182139OtherCIGNA
FL003938300Medicaid
FLPENDINGOtherAVMED
FLFF992ZMedicare UPIN