Organization
BAYCARE CLINIC, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS JAY AUGUSTIAN C.P.A (CHIEF EXECUTIVE OFFICER)
(920) 405-5382
Entity
Organization
Contact information
Practice address
725 S WEBSTER AVE, GREEN BAY, WI 54301-3500
(920) 288-8350
(920) 288-8355
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588609648
—
WI
Enumeration date
02/16/2012
Last updated
04/13/2022
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