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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
1400 UNIVERSITY DR, SUITE 101, MARINETTE, WI 54143-5105
(715) 732-4181
(715) 732-1348
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35480
WI
Other
Enumeration date
09/30/2015
Last updated
08/27/2026
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