1760599559 NPI number — JON F GEERS, MD PC

Table of content: (NPI 1760599559)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760599559 NPI number — JON F GEERS, MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JON F GEERS, MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760599559
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 68952
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46268-0952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-802-3138
Provider Business Mailing Address Fax Number:
317-870-0499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
188 STATE ROAD 129 S
Provider Second Line Business Practice Location Address:
SUITE #A
Provider Business Practice Location Address City Name:
BATESVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47006-7628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-934-9191
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GEERS
Authorized Official First Name:
JON
Authorized Official Middle Name:
F
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
812-934-9191

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  01045117 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200892660 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com