DR. RUSSELL BRANDON WATTERS III MD NPI 1003872201

Internal Medicine in Etowah, TN

About RUSSELL WATTERS

Russell Watters is a provider in Etowah, TN with more than 29 years of experience. The NPI number assigned to this provider is 1003872201. The practitioner's primary taxonomy code is Internal Medicine (207R00000X). The provider is registered as an individual and their NPI record was last updated 10 years ago. Russell Watters is registered with Medicare and accepts claims assignment.

NPI1003872201 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. RUSSELL BRANDON WATTERS III MD
Provider Location Address301 GRADY RD ETOWAH, TN 37331 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 325 ETOWAH, TN 37331 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameUNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE
Graduation Year1989
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-25-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date11-07-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. RUSSELL BRANDON WATTERS III MD
301 GRADY RD
ETOWAH, TN
ZIP 37331
Phone: (423) 263-2444
Fax: (423) 263-1553
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Mailing Address

DR. RUSSELL BRANDON WATTERS III MD
PO BOX 325
ETOWAH, TN
ZIP 37331
Phone: (423) 263-2444
Fax: (423) 263-1553

Primary Taxonomy

Taxonomy Code207R00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.023529
License StateTN
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
E44337MEDICARE UPIN (02)
3069752MEDICAID (05)TN
2008341OTHER (01)TN
3069753MEDICARE PIN (08)TN

Map Location


DR. RUSSELL BRANDON WATTERS III MD address is 301 GRADY RD ETOWAH, TN 37331

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1447593041MRS. JAMIE MORGAN MILLER FNP
Individual
Nurse Practitioner (Family)301 GRADY RD
ETOWAH, TN 37331
(423) 263-2444
1659338044DR. JOEL CRAIG RILEY II MD
Individual
Internal Medicine301 GRADY RD
ETOWAH, TN 37331
(423) 263-2444
1760448591DR. SAMUEL JOHN OLSEN II MD
Individual
Internal Medicine301 GRADY RD
ETOWAH, TN 37331
(423) 263-2444