Individual
DR. WALTER EDWIN WATTS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 ROCKEFELLER DR, MUSKOGEE, OK 74401-5075
(918) 488-6057
Mailing address
300 ROCKEFELLER DR, MUSKOGEE, OK 74401-5075
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
2015038139
MO
2085R0001X
Radiation Oncology Physician
Primary
27100
OK
2085R0203X
Therapeutic Radiology Physician
27100
OK
Other
Enumeration date
06/18/2008
Last updated
09/02/2024
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