Provider Demographics
NPI:1841261377
Name:WATTS, WILLIAM FREDERICK (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FREDERICK
Last Name:WATTS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LOW ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4048
Mailing Address - Country:US
Mailing Address - Phone:978-462-2020
Mailing Address - Fax:978-462-4263
Practice Address - Street 1:33 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-4048
Practice Address - Country:US
Practice Address - Phone:978-462-2020
Practice Address - Fax:978-462-4263
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2235152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0317519Medicaid
MA15914OtherHARVARD
MA542065263OtherHEALTH CARE VALUE MANAGMT
MA542065263OtherUNITED HEALTH
MA0023858OtherNEIGHBORHOOD HEALTH PLAN
MA702537OtherTUFTS
MA70010000W15236OtherBLUE CROSS & BLUE SHIELD
MA542065263OtherUNITED HEALTH
MAT59176Medicare UPIN