| Doctor Name: | BEAU WATTS |
| NPI Number: | 1093933632 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2411 Holmes St Umkc School Of Medicine Residency Program, M1-210 Kansas City, MO - 641082741 |
| Business Phone Number: | 8162356626 |
| Business Fax Number: | 8162356629 |
| Mailing Address: | 691 Watts Rd, ROGERSVILLE |
| State: | MO |
| Postal Code: | 657427711 |
| Phone Number: | 4022125435 |
| Fax Number: | |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |