Individual
DR. JASON C WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3510 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 776-3100
(765) 453-8165
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01073732A
IN
207X00000X
Orthopaedic Surgery Physician
ME149168
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201109280
—
IN
Enumeration date
05/25/2009
Last updated
01/14/2025
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