Watters, Thomas

Watters, Thomas is an individual health care provider with primary practice located at 125 Buena Vista Cir , South Hill VA 23970-1431. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Watters, Thomas can be contacted via phone (952) 442-9770.

Contact Information

Primary practice address
125 Buena Vista Cir South Hill VA 23970-1431
Phone: (952) 442-9770
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0001036832 Virginia

Profile Details

NPI number 1417939224
LBN Legal business name Watters, Thomas
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Apr 28th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417939224 NPPES
Virginia Other 080567 BLUE CROSS OF VA
Virginia MEDICAID 9550020 BLUE CROSS OF VA

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