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DR. DANIEL JOHN WATTENDORF M.D.
NPI 1760496178
Medical Genetics - Clinical Cytogenetics in Keesler Afb, MS

Active since July 28, 2006PECOS Enrolled
301 FISHER ST, RM 1A132, KEESLER AFB, MS 39534(228) 377-6393(228) 377-6304 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Daniel John Wattendorf M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DANIEL JOHN WATTENDORF M.D. (NPI 1760496178) is an individual clinical cytogenetics provider in Keesler Afb, Mississippi, licensed in Pennsylvania (MD067656L) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760496178
Entity TypeIndividualMale
Primary Taxonomy207SC0300X
Provider Legal NameDR. DANIEL JOHN WATTENDORFCredential: M.D.
Location Address301 FISHER ST, RM 1A132Keesler Afb, MS 39534-2159
Mailing Address301 Fisher St, Rm 1a132Keesler Afb, MS 39534-2159 · (228) 377-6393 · Fax (228) 377-6304
Phone(228) 377-6393
Fax(228) 377-6304
Sole ProprietorNo
Enumeration DateJuly 28, 2006
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1760496178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMedical Genetics · Clinical CytogeneticsAllopathic & Osteopathic Physicians
Taxonomy Code207SC0300X
License✔ Licensed in PA · MD067656L
Definition
A clinical cytogeneticist demonstrates competence in providing laboratory diagnostic and clinical interpretive services dealing with cellular components, particularly chromosomes, associated with heredity.
Also ListedFamily MedicineTaxonomy 207Q00000X · License MD067656L (PA)
Also ListedMedical Genetics · Clinical Genetics (M.D.)Taxonomy 207SG0201X · License MD067656L (PA)

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Daniel John Wattendorf M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTINA MARIE DUKES PHARMD
Pharmacist (Oncology)
301 FISHER ST, KEESLER AFB
KEESLER AFB, MS 39534
Harrison County (228) 376-4637
DR. BRICE PETER BOWERMAN MD
Radiology (Diagnostic Radiology)
301 FISHER ST
BILOXI, MS 39534
Harrison County (678) 394-6561
BENNETT ALAN LUCAS MD
Military Health Care Provider
301 FISHER ST
BILOXI, MS 39534
Harrison County (228) 376-2273
DR. DAVID MAX JONES D.D.S.
Dentist (General Practice)
301 FISHER ST
KEESLER AFB, MS 39534
Harrison County (228) 376-0512
JILL ALLYN JOZEFOWICZ DO
Surgery
301 FISHER ST
KEESLER AFB, MS 39534
Harrison County (228) 376-0425
DR. JOSEPH CAMORATTO DPT
Physical Therapist
301 FISHER ST
BILOXI, MS 39534
Harrison County (228) 376-5231
KYLE QUIST
Internal Medicine
301 FISHER ST
BILOXI, MS 39534
Harrison County (601) 988-4698
YVONNE MARIE SCULLEY MD
Obstetrics & Gynecology
301 FISHER ST
KEESLER AFB, MS 39534
Harrison County (228) 376-4118

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Daniel Wattendorf's NPI number?

The NPI number for Daniel Wattendorf is 1760496178. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Daniel Wattendorf located?

Daniel Wattendorf practices at 301 Fisher St Rm 1a132, Keesler Afb, MS 39534. The listed phone number is (228) 377-6393.

What is Daniel Wattendorf's specialty?

The primary specialty registered for this NPI is Medical Genetics, specializing in Clinical Cytogenetics, with taxonomy code 207SC0300X.

Is Daniel Wattendorf enrolled in Medicare?

Yes. Daniel Wattendorf is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Daniel Wattendorf was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.