Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 000612 | MO |
NPI | 1053429779 |
---|---|
Provider Name | Dr. Perry Kent Geistler |
First Address | Saint Louis, MO 63128-1779 |
Second Address | Saint Louis, MO 63128-1779 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 29/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U30241 | (02) | MO |