MEDICARE: DR. AARON T WATTERS MD

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	04-24915	KS

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

General Provider Information

NPI Number	:	1093717381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON T WATTERS MD

Provider Business Mailing Address
First Line	:	708 COMMERCIAL ST
Second Line	:
City	:	EMPORIA
State	:	KS
Zip	:	66801
Country	:	US
Telephone Number	:	620-263-3777
Fax Number	:	620-263-3774

Provider Business Practice Location Address
First Line	:	708 COMMERCIAL ST
Second Line	:
City	:	EMPORIA
State	:	KS
Zip	:	66801
Country	:	US
Telephone Number	:	620-263-3777
Fax Number	:	620-263-3774

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	11/08/2024

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