Individual
JAYA PHOOKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
66307
WI
208M00000X
Hospitalist Physician
Primary
66307
WI
Other
Enumeration date
07/23/2009
Last updated
11/30/2021
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