MEDICARE: DR. JOEL 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	283Q00000X	Psychiatric Hospital	092261	OH

General Provider Information

NPI Number	:	1750531356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL WATTS M.D.

Provider Business Mailing Address
First Line	:	2419 OVERLOOK ROAD
Second Line	:	APARTMENT 15
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-333-1447
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 OVERLOOK RD
Second Line	:	APARTMENT 15
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-2436
Country	:	US
Telephone Number	:	216-333-1447
Fax Number	:

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

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	09/19/2008

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