Individual
DR. GORDON GLENN ROEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2223 LIME KILN RD STE 1, GREEN BAY, WI 54311-6213
(920) 430-8113
(920) 430-8122
Mailing address
2223 LIME KILN RD STE 1, GREEN BAY, WI 54311-6213
(920) 430-8113
(920) 430-8122
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
8109
NE
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
82150
WI
Other
Enumeration date
06/29/2017
Last updated
08/18/2023
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