# GREEN BAY CHEST AND INFECTIOUS DISEASES SC

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

## Provider details

- **NPI number:** 1538356985
- **Authorized official:** DR. RONALD DALE DAVIS M.D. (PRESIDENT)
- **Authorized official phone:** (920) 433-7516

## Contact information

- **Practice address:** 704 S WEBSTER AVE, SUITE 102, GREEN BAY, WI 54301-3528
- **Practice address phone:** (920) 433-7516
- **Practice address fax:** (920) 433-7464
- **Mailing address:** 704 S WEBSTER AVE, SUITE 102, GREEN BAY, WI 54301-3528
- **Mailing address phone:** (920) 433-7516
- **Mailing address fax:** (920) 433-7464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | 30054 | WI | Yes |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 10/12/2007