Organization
MICHAEL D. WATTS, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DAVID WATTS O.D. (PRESIDENT)
(812) 275-7806
Entity
Organization
Contact information
Practice address
1506 BEECH ST, BEDFORD, IN 47421-3014
(812) 275-7806
(812) 275-7852
Mailing address
1506 BEECH ST, BEDFORD, IN 47421-3014
(812) 275-7806
(812) 275-7852
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001713A
IN
332H00000X
Eyewear Supplier
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200887880A
—
IN
Enumeration date
01/14/2008
Last updated
05/01/2008
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