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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
30 N 18TH AVE, STURGEON BAY, WI 54235-3207
(920) 743-9532
(920) 743-9538
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
WI
207W00000X
Ophthalmology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588609648
—
WI
Enumeration date
02/27/2012
Last updated
08/27/2026
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