MEDICARE: JONATHAN MICHAEL 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	2085N0700X	Neuroradiology Physician	2010-00804	NC
2	2085R0202X	Diagnostic Radiology Physician	2010-00804	NC

General Provider Information

NPI Number	:	1487882528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN MICHAEL WATTS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 95460
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-0033
Country	:	US
Telephone Number	:	602-581-6076
Fax Number	:	602-263-1619

Provider Business Practice Location Address
First Line	:	1331 N. ELM STREET
Second Line	:	STE. 200
City	:	GREENSBORO
State	:	NC
Zip	:	27401-6304
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:	336-482-2177

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

Provider Enumeration Date	:	06/28/2009
Last Update Date	:	04/21/2026

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