# METROPOLITAN WATERTOWN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023288800
- **Authorized official:** NEIL TABAKIN MD (ANESTHESIOLOGIST/TREASURER)
- **Authorized official phone:** (414) 617-9941

## Contact information

- **Practice address:** 125 HOSPITAL DR, WATERTOWN, WI 53098-3303
- **Practice address phone:** (920) 262-4210
- **Mailing address:** 804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
- **Mailing address phone:** (800) 394-4445
- **Mailing address fax:** (706) 650-1034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | WI | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | WI | Yes |

## Other

- **Enumeration date:** 03/07/2008
- **Last updated:** 07/21/2022