Organization
WATERTOWN ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY O BERGSBAKEN MD (OWNER/MD)
(605) 335-1952
Entity
Organization
Contact information
Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
Mailing address
PO BOX 3353, OMAHA, NE 68103-0353
(605) 335-1952
(605) 373-9971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH3925
RAILROAD MEDICARE
—
Enumeration date
07/28/2006
Last updated
01/29/2020
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