Healthcare Provider Details

I. General information

NPI: 1578619490
Provider Name (Legal Business Name): HELEN ELIZABETH WATT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 E OSBORN DR STE 240
SCOTTSDALE AZ
85251-6422
US

IV. Provider business mailing address

PO BOX 28876
SCOTTSDALE AZ
85255-0164
US

V. Phone/Fax

Practice location:
  • Phone: 480-368-9608
  • Fax: 480-686-9007
Mailing address:
  • Phone: 480-368-9608
  • Fax: 480-686-9007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number22016
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22016
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number22016
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: