Basic Information
| Provider Information | |||||||||
| NPI: | 1891833174 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WATTS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | CHESTER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 15TH ST NE | ||||||||
| Address2: | APT 1032 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303093535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045752182 | ||||||||
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| Practice Location | |||||||||
| Address1: | 531 ROSELANE ST NW | ||||||||
| Address2: | SUITE 750 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300606913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707940477 | ||||||||
| FaxNumber: | 7707943108 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 12/05/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 033221 | GA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.