Provider Demographics
NPI:1366414807
Name:WATERTOWN ORTHOPEDICS LTD
Entity type:Organization
Organization Name:WATERTOWN ORTHOPEDICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-261-8011
Mailing Address - Street 1:123 HOSPITAL DR
Mailing Address - Street 2:STE 1008
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-3335
Mailing Address - Country:US
Mailing Address - Phone:920-261-8011
Mailing Address - Fax:920-261-4013
Practice Address - Street 1:123 HOSPITAL DR
Practice Address - Street 2:STE 1008
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-3335
Practice Address - Country:US
Practice Address - Phone:920-261-8011
Practice Address - Fax:920-261-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36420207X00000X
WI28583207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty