Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 7512 | AZ |
N | 1223G0001X | General Practice | 21734 | MA |
N | 213EG0000X | General Practice | 21734 | MA |
NPI | 1073648754 |
---|---|
Provider Name | Dr. Robert K Watts |
First Address | Scottsdale, AZ 85255-6216 |
Second Address | Scottsdale, AZ 85255-6216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 27/04/2009 |