DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WATERTOWN MEDICAL CENTER LLC

MEDICARE: WATERTOWN MEDICAL CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory
2282N00000XGeneral Acute Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992776041
Entity Type Code : Organization
Provider Name (Legal Business Name) : WATERTOWN MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : 680 S 4TH ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-2407
Country : US
Telephone Number : 502-596-6063
Fax Number :
Provider Business Practice Location Address
First Line : 125 HOSPITAL DR
Second Line :
City : WATERTOWN
State : WI
Zip : 53098-3303
Country : US
Telephone Number : 920-261-4210
Fax Number :
Authorized Official
Title or Position : AO
Name : JOHNETTA TRAYLOR
Credential :
Telephone Number : 502-596-6063
Provider Enumeration Date : 01/27/2006
Last Update Date : 06/25/2025

Similar Medicare Providers

1972505154 — WATERTOWN REGIONAL MEDICAL CENTER, INC
Practice Location Address:
125 HOSPITAL DR
WATERTOWN, WI
53098-3303
Practice Phone: 920-261-4210
Practice Fax:
1871597211 — ALAN L. DETWILER MD
Practice Location Address:
125 HOSPITAL DR
WATERTOWN, WI
53098-3303
Practice Phone: 920-262-4210
Practice Fax:
1013908771 — DR. ROBERT STEVEN LEGROW M.D.
Practice Location Address:
127 HOSPITAL DR
WATERTOWN, WI
53098-3303
Practice Phone: 920-261-8500
Practice Fax: 920-261-8828
1205803947 — KATHLEEN M HARGARTEN MD
Practice Location Address:
125 HOSPITAL DR
WATERTOWN, WI
53098-3303
Practice Phone: 920-261-4210
Practice Fax: 920-262-4360
1265409965 — EDWARD J FOSTER MD
Practice Location Address:
125 HOSPITAL DR
WATERTOWN, WI
53098-3303
Practice Phone: 920-261-4210
Practice Fax: 920-262-4360
1396712469 — JASON H LEE MD
Practice Location Address:
125 HOSPITAL DR
WATERTOWN, WI
53098-3303
Practice Phone: 920-261-4210
Practice Fax: 920-262-4360

Directions to “WATERTOWN MEDICAL CENTER LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.