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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
629 SOLVANG WAY, DENMARK, WI 54208-8951
(920) 863-2600
(920) 863-3865
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
29836
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588609648
WI
Enumeration date
08/20/2013
Last updated
04/20/2022
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