Organization
WATERTOWN PHYSICIAN PRACTICES LLC
Active
Other names
Watertown Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (AO)
(502) 596-6063
Entity
Organization
Contact information
Practice address
132 HOSPITAL DR, WATERTOWN, WI 53098-3304
(920) 261-2020
(920) 261-0457
Mailing address
680 S 4TH ST # KH-3, LOUISVILLE, KY 40202-2407
(502) 596-6063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/29/2018
Last updated
06/23/2025
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