Provider Demographics
NPI:1881609766
Name:HARRY C WATTERS DO MPH PC
Entity type:Organization
Organization Name:HARRY C WATTERS DO MPH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WATTERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:480-963-7900
Mailing Address - Street 1:604 W WARNER RD STE E201
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2911
Mailing Address - Country:US
Mailing Address - Phone:480-963-7900
Mailing Address - Fax:480-963-0621
Practice Address - Street 1:604 W WARNER RD STE E201
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2911
Practice Address - Country:US
Practice Address - Phone:480-963-7900
Practice Address - Fax:480-963-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ70153Medicare ID - Type UnspecifiedGROUP NUMBER