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NPI Code Detail

MEDICARE: DR. JUBAL R WATTS M.D.

MEDICARE:  DR. JUBAL R 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
1207X00000XOrthopaedic Surgery Physician16298GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033100037
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUBAL R WATTS M.D.
Provider Business Mailing Address
First Line : 150 CLINIC AVE
Second Line : STE 101
City : CARROLLTON
State : GA
Zip : 30117-4401
Country : US
Telephone Number : 770-834-0873
Fax Number : 770-834-6118
Provider Business Practice Location Address
First Line : 150 CLINIC AVE
Second Line : STE 101
City : CARROLLTON
State : GA
Zip : 30117-4401
Country : US
Telephone Number : 770-834-0873
Fax Number : 770-834-6118
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 06/24/2013

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Directions to “ DR. JUBAL R WATTS M.D.” Practice Location

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