# DOCTORS PARK APPLETON LLC

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

## Provider details

- **NPI number:** 1205750635
- **Authorized official:** KEVAN LEWIS (OWNER)
- **Authorized official phone:** (920) 965-0345

## Contact information

- **Practice address:** 3400 N CONKEY ST. SUITE S, APPLETON, WI 54911
- **Practice address phone:** (920) 965-0345
- **Mailing address:** 3400 N CONKEY ST. SUITE S, APPLETON, WI 54911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/07/2026
- **Last updated:** 08/07/2026