Healthcare Provider Details

I. General information

NPI: 1699691493
Provider Name (Legal Business Name): APOGEE MEDICAL GROUP, GREEN BAY, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 S WEBSTER AVE
GREEN BAY WI
54301-3505
US

IV. Provider business mailing address

PO BOX 25016
DALLAS TX
75225-1016
US

V. Phone/Fax

Practice location:
  • Phone: 920-433-7970
  • Fax:
Mailing address:
  • Phone: 214-592-1329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENTRY LANGFORD
Title or Position: DIRECTOR OF PROVIDER ENROLLMENT
Credential:
Phone: 972-269-1907