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General NPI Number Information
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NPI Number | 1285064394
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Entity Type | Individual
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Provider Name | GUY D WATTS MD
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Gender | Male
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 310 E 14TH ST ROOM 901
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City | NEW YORK
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State | NY
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Zip | 10003-4201
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Country | US
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Telephone | 917-306-9912
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Fax |
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Provider Business Mailing Address
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Address Line | UNIT 1, 14 COLLINGWOOD AVENUE HAZELWOOD PARK
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City | ADELAIDE
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State | SOUTH AUSTRALIA
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Zip | 5066
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Country | AU
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | P87619
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License Number State | NY
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