Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 01044147A | IN |
NPI | 1437146081 |
---|---|
Provider Name | John P. Geisler |
First Address | Toledo, OH 43614-2426 |
Second Address | Fort Wayne, IN 46825-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 24/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200425790 | (05) | IN |
H05420 | (02) | IN |