Individual
BAILEY E HAVLOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
720 S VANBUREN ST, GREEN BAY, WI 54301-3504
(920) 468-3444
(920) 432-6313
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5720-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1175013
NATIONAL COMMISSION ON CERTIFIED PHYSICIAN ASSISTANTS
—
Enumeration date
05/24/2021
Last updated
10/31/2025
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