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General NPI Number Information
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NPI Number | 1528412673
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Entity Type | Organization
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Legal Business Name | OCONTO HOSPITAL & MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 2820 ROOSEVELT ROAD
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City | MARINETTE
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State | WI
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Zip | 54143-3834
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Country | US
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Telephone | 920-445-7226
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Fax | 920-445-7229
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Provider Business Mailing Address
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Address Line | PO BOX 1866
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City | GREEN BAY
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State | WI
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Zip | 54305-1866
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Country | US
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Telephone | 920-445-7210
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Fax | 920-445-7289
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ABBY J ENGEBOSE
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Credential |
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Telephone | 920-433-7860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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