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General NPI Number Information
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NPI Number | 1346408275
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Entity Type | Organization
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Legal Business Name | WATERTOWN REGIONAL MEDICAL CENTER, INC
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 123 HOSPITAL DR STE 2006
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City | WATERTOWN
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State | WI
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Zip | 53098-3320
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Country | US
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Telephone | 920-261-1334
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Fax | 920-261-8755
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Provider Business Mailing Address
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Address Line | PO BOX 684088
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City | CHICAGO
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State | IL
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Zip | 60695-4088
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Country | US
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Telephone | 920-262-4784
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Fax | 920-262-4640
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Authorized Official
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Title or Position | DIRECTOR- PATIENT ACCOUNTING
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Name | MR. ROBERT JAMES KLUGE
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Credential |
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Telephone | 920-262-4784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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