Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 300026 | LA |
NPI | 1023121035 |
---|---|
Provider Name | Raymond G. Watts |
First Address | New Orleans, LA 70118 |
Second Address | New Orleans, LA 70118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000018757 | (05) | AL |
000028883 | (05) | AL |
2404857 | (05) | LA |
C76911 | (02) |