# WATERTOWN REGIONAL MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WATERTOWN REGIONAL MEDICAL CENTER, NNC
- **Other names:** UWHP WRMC Center For Eye Care - Johnson Creek
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003146929
- **Legal business name:** WATERTOWN REGIONAL MEDICAL CENTER, NNC
- **Authorized official:** ROBERT J KLUGE (PATIENT FINANCIAL SERVICES MANAGER)
- **Authorized official phone:** (920) 262-4784

## Contact information

- **Practice address:** 540 VILLAGE WALK LN, STE G, JOHNSON CREEK, WI 53038-9554
- **Practice address phone:** (920) 699-4388
- **Mailing address:** 125 HOSPITAL DR, WATERTOWN, WI 53098-3303
- **Mailing address phone:** (920) 262-4784
- **Mailing address fax:** (920) 262-4640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | WI | Yes |

## Other

- **Enumeration date:** 12/29/2009
- **Last updated:** 03/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100007050 | — | WI |