# GREEN BAY ALLERGY ASTHMA & IMMUNOLOGY S.C. OCONTO

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

## Provider details

- **NPI number:** 1922167402
- **Authorized official:** JAMES W ALLEN MD (OWNER)
- **Authorized official phone:** (920) 336-5620

## Contact information

- **Practice address:** 203 SMITH AVE STE 1, OCONTO, WI 54153-1060
- **Practice address phone:** (920) 834-8833
- **Mailing address:** 203 SMITH AVE STE 1, OCONTO, WI 54153-1060
- **Mailing address phone:** (920) 834-8833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 04/20/2008