Provider Demographics
NPI:1841098308
Name:VAN DER WATT PROSTHETICS & ORTHOTICS
Entity type:Organization
Organization Name:VAN DER WATT PROSTHETICS & ORTHOTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DER WATT
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:479-357-1840
Mailing Address - Street 1:1090 FORT ST
Mailing Address - Street 2:
Mailing Address - City:BARLING
Mailing Address - State:AR
Mailing Address - Zip Code:72923-2159
Mailing Address - Country:US
Mailing Address - Phone:479-551-2462
Mailing Address - Fax:
Practice Address - Street 1:1090 FORT ST STE A
Practice Address - Street 2:
Practice Address - City:BARLING
Practice Address - State:AR
Practice Address - Zip Code:72923-2159
Practice Address - Country:US
Practice Address - Phone:479-551-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier