1891754784 NPI number — PAUL L GEIGER JR. DO

Table of content: PAUL L GEIGER JR. DO (NPI 1891754784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891754784 NPI number — PAUL L GEIGER JR. DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEIGER
Provider First Name:
PAUL
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GEIGER
Provider Other First Name:
SKIP
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1891754784
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2580
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65801-2580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-829-4620
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8840 BENBROOK BLVD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENBROOK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76126-2173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-813-7101
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  108506 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: Q9615 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 010062129 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100005790 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100288780A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100317800B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100288780C , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 249797101 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00119337 . This is a "RAILROAD MCR WATHEN MEDICAL CENTER" identifier . This identifiers is of the category "OTHER".




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