Basic Information
| Provider Information | |||||||||
| NPI: | 1881624468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEITZ | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MELVIN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GEITZ | ||||||||
| OtherFirstName: | JAMES | ||||||||
| OtherMiddleName: | M | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 907 | ||||||||
| Address2: | |||||||||
| City: | EMPORIA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 668010907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203422521 | ||||||||
| FaxNumber: | 6203426520 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 WEST 12TH AVE | ||||||||
| Address2: | STE 202 | ||||||||
| City: | EMPORIA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 668010970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203422521 | ||||||||
| FaxNumber: | 6203426520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 15340 | KS | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.