Provider Demographics
NPI:1134422918
Name:DONALD H. WATTERS MD
Entity type:Organization
Organization Name:DONALD H. WATTERS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:WATTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-507-8369
Mailing Address - Street 1:711 COOK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-3486
Mailing Address - Country:US
Mailing Address - Phone:423-507-8369
Mailing Address - Fax:423-507-8387
Practice Address - Street 1:711 COOK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3486
Practice Address - Country:US
Practice Address - Phone:423-507-8369
Practice Address - Fax:423-507-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty