Provider Demographics
NPI:1255370755
Name:WATTS, DAVID REED (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:REED
Last Name:WATTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:3024 BUSINESS PARK CIR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3132
Practice Address - Country:US
Practice Address - Phone:615-851-6033
Practice Address - Fax:615-851-2018
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD168202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509320OtherMEDICAID - MTI
TNPENDINGOtherRAILROAD MEDICARE
TN1509320Medicaid
TN3193291Medicaid
TN4201118OtherBCBS TN
TN4068887OtherBCBS
TN4018027OtherBCBS
KY64721152OtherKY MEDICAID
TN4291401OtherBCBS - MTI
TN3193297Medicare PIN
TN31932911Medicare PIN
TN4291401OtherBCBS - MTI
TN1509320Medicaid
TNPENDINGOtherRAILROAD MEDICARE