Organization
BAYCARE CLINIC LLP
Active
Parent organization
BAYCARE CLINIC LLP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYCARE CLINIC LLP
Authorized official
MR. CHRIS JAY AUGUSTINE C.P.A. (CHIEF EXECUTIVE OFFICER)
(920) 405-5382
Entity
Organization
Contact information
Practice address
2581 DEVELOPMENT DR, GREEN BAY, WI 54311-4247
(920) 347-0400
(920) 347-0868
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 405-5388
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
05/22/2007
Last updated
04/13/2022
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