Dr Daniel John Wattendorf, MD is a
Medical Genetics - Clinical Cytogenetics physician based in Keesler Afb, Mississippi. Dr Daniel John Wattendorf is licensed to practice in Pennsylvania (license number MD067656L) and his current practice location is 301 Fisher St, Rm 1a132, Keesler Afb, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(228) 377-6393.
NPI number for Dr Daniel John Wattendorf is 1760496178 and his current mailing address is 301 Fisher St, Rm 1a132, Keesler Afb, Mississippi. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1760496178.
Physician's Profile
| Full Name | Dr Daniel John Wattendorf |
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| Gender | Male |
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| Speciality | Medical Genetics - Clinical Cytogenetics |
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| Location | 301 Fisher St, Keesler Afb, Mississippi |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1760496178
- Provider Enumeration Date: 07/28/2006
- Last Update Date: 09/11/2025
Medical Identifiers
Medical identifiers for Dr Daniel John Wattendorf such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760496178 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | MD067656L (Pennsylvania) | Secondary |
| 207SC0300X | Medical Genetics - Clinical Cytogenetics | MD067656L (Pennsylvania) | Primary |
| 207SG0201X | Medical Genetics - Clinical Genetics (m.d.) | MD067656L (Pennsylvania) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Daniel John Wattendorf is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Daniel John Wattendorf, MD
301 Fisher St, Rm 1a132,
Keesler Afb, MS 39534-2159
Ph: (228) 377-6393 | Dr Daniel John Wattendorf, MD
301 Fisher St, Rm 1a132,
Keesler Afb, MS 39534-2159
Ph: (228) 377-6393 |
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