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Organization
BAYCARE CLINIC, LLP
Active
Organization
BAYCARE CLINIC, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR KONKLE (PAYOR ENROLLMENT)
(920) 301-1327
Entity
Organization
Contact information
Practice address
2401 HOLMGREN WAY, GREEN BAY, WI 54304-5224
(920) 497-0003
(920) 497-0024
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
Other
Enumeration date
02/28/2012
Last updated
08/27/2026
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