GREEN BAY ONCOLOGY, LTD – NPI #1649214941
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

GREEN BAY ONCOLOGY, LTD is a provider located in GREEN BAY, WI. NPPES has assigned the NPI number 1649214941 to GREEN BAY ONCOLOGY, LTD on June 16, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207RH0003X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Hematology & Oncology

The NPI profile was previously updated about 12 years ago on Oct 28, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GREEN BAY ONCOLOGY, LTD below.

NPI Profile for
GREEN BAY ONCOLOGY, LTD

NPI Number
1649214941
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GREEN BAY ONCOLOGY, LTD
Primary location
1726 SHAWANO AVE
GREEN BAY, WI 54303
Phone: (920) 884-3135 Fax: (920) 884-3271
Mailing address
1726 SHAWANO AVE.
GREEN BAY, WI 54303
Phone: (920) 884-3135 Fax: (920) 884-3271
Organization Subpart
No
Authorized Official
GINA MOON
CFO
Phone: (920) 965-9526
Updated
Identifiers

Identifiers for GREEN BAY ONCOLOGY, LTD

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBCBS GROUPMI110B210240
OTHERDMERC0189920001
OTHERRR MEDICAREO1037
MEDICAIDWI32769100
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RH0003X
- Internal Medicine / Hematology & Oncology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.