| Organization Name: | WATERTOWN REGIONAL MEDICAL CENTER, INC |
| NPI Number: | 1265720015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT JAMES KLUGE (DIRECTOR-PATIENT ACCOUNTING) |
| Mailing Address: | 524 Milwaukee St Suite 180 Delafield |
| State: | WI US |
| Postal Code: | 530181462 |
| Phone Number: | 9202624449 |
| Fax Number: | 9202624533 |
| NPI Enumeration Date: | 07/14/2011 |
| NPI Last Update Date: | 12/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |