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Organization
WATERTOWN REGIONAL MEDICAL CENTER INC
Active
Organization
WATERTOWN REGIONAL MEDICAL CENTER INC
Active
Parent organization
WATERTOWN REGIONAL MEDICAL CENTER INC
Other names
UWHP WRMC Lake Mills Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
WATERTOWN REGIONAL MEDICAL CENTER INC
Authorized official
MR. ROBERT JAMES KLUGE (DIRECTOR PATIENT ACCOUNTING)
(920) 262-4784
Entity
Organization
Contact information
Practice address
1025 MULBERRY ST, LAKE MILLS, WI 53551-1304
(920) 648-4518
Mailing address
PO BOX 684088, CHICAGO, IL 60695-4088
(920) 262-4640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21266900
—
WI
Enumeration date
10/31/2007
Last updated
03/19/2014
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