Organization
JAMES F. WATT DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON M FUNK (BUSINESS OFFICE LIASON)
(850) 315-9212
Entity
Organization
Contact information
Practice address
1034 MAR WALT DR, SUITE 100, FORT WALTON BEACH, FL 32547-6639
(850) 863-2153
(850) 863-8085
Mailing address
1034 MAR WALT DR, SUITE 100, FORT WALTON BEACH, FL 32547-6639
(850) 863-2153
(850) 863-8085
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14E4H
BCBS PROVIDER MUMBER
—
Enumeration date
08/31/2012
Last updated
09/07/2012
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