Individual
DR. JEFFREY WATABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
324 E 10TH AVE STE 178, SALT LAKE CITY, UT 84103-2885
(801) 408-8500
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 585-5545
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5536076-1205
UT
Other
Enumeration date
10/12/2006
Last updated
05/09/2019
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