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Individual

JASON DOUGLAS RETZKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
704 S WEBSTER AVE, GREEN BAY, WI 54301-3528
(920) 338-6868
(920) 338-6869
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35090824
OH
207VM0101X
Maternal & Fetal Medicine Physician
35090824
OH
207VM0101X
Maternal & Fetal Medicine Physician
Primary
82799-20
WI

Other

Enumeration date
02/27/2008
Last updated
09/29/2023
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