He received his early education in private schools in Baltimore, and graduated from the University of Maryland in 1871 with a degree in civil engineering.

[2] He helped establish the congregation at Trinity Avenue Presbyterian Church for workers at one of his cotton mills.

Years later, "Hated St." was changed to "Gregson St." In 1890, Watts helped organize the American Tobacco Co. and in 1892, the Erwin Cotton Mills Company.

Watts was heavily involved in other businesses as well, as listed below: By 1922, Watts Hospital's quality of care and philanthropic mission to provide healthcare to the working poor was so well-regarded that James B. Duke and North Carolina Governor Cameron Morrison proposed the creation of the state's first four-year medical college, Duke University.

[6] Watts SON has been housed at Durham Regional Hospital since 1976, and is now a part of the Duke University Health System.