MEDICARE: JANA WATTS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2001-00981	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2320987	OTHER	NC	UNITED HEALTH CARE
3	134G9	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1215934930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA WATTS M.D.

Provider Business Mailing Address
First Line	:	1388 SAND HILL RD
Second Line	:
City	:	CANDLER
State	:	NC
Zip	:	28715-8937
Country	:	US
Telephone Number	:	828-213-5335
Fax Number	:	828-213-5336

Provider Business Practice Location Address
First Line	:	1388 SAND HILL RD
Second Line	:
City	:	CANDLER
State	:	NC
Zip	:	28715-8937
Country	:	US
Telephone Number	:	828-213-5335
Fax Number	:	828-213-5336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/31/2022

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