ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS OF GREEN BAY SC NPI 1760670145

NPI Information

ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS OF GREEN BAY, SC is a specialist in Green Bay, WI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS OF GREEN BAY, SC NPI is 1760670145. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2223 LIME KILN RD
SUITE 1
GREEN BAY, WI
ZIP 54311-213
Phone: (920) 430-8120
Fax: (920) 430-8122

The provider's authorized official is Katie Klaus .
The authorized official title is Provider Credentialing And Privileg and has the following contact phone number (920) 965-9517.

The CLIA number assigned to this NPI record is 52D2192975 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/10/2007 and was last updated on 4/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.