# OB-GYN ASSOC OF GREEN BAY LTD

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

## Provider details

- **NPI number:** 1154400034
- **Authorized official:** ROBERT KNOX DEMOTT MD (OWNER OPERATOR)
- **Authorized official phone:** (920) 468-3443

## Contact information

- **Practice address:** 704 S WEBSTER AVE, STE 300, GREEN BAY, WI 54301
- **Practice address phone:** (920) 468-3443
- **Practice address fax:** (920) 432-6313
- **Mailing address:** 1350 WITTMANN DRIVE, HEALTHCARE MANAGEMENT CONSULTANTS, MENASHA, WI 54952-3809
- **Mailing address phone:** (920) 886-6565
- **Mailing address fax:** (920) 886-6570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VC0200X | Critical Care Medicine (Obstetrics & Gynecology) Physician | — | WI | Yes |
| 364SF0001X | Family Health Clinical Nurse Specialist | — | WI | — |

## Other

- **Enumeration date:** 11/03/2006
- **Last updated:** 07/01/2008