# WATERTOWN ANESTHESIA PC

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

## Provider details

- **NPI number:** 1215941117
- **Authorized official:** JEFFREY O BERGSBAKEN MD (OWNER/MD)
- **Authorized official phone:** (605) 335-1952

## Contact information

- **Practice address:** 401 9TH AVE NW, WATERTOWN, SD 57201-1548
- **Practice address phone:** (605) 882-7000
- **Mailing address:** PO BOX 3353, OMAHA, NE 68103-0353
- **Mailing address phone:** (605) 335-1952
- **Mailing address fax:** (605) 373-9971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 01/29/2020