Basic Information
| Provider Information | |||||||||
| NPI: | 1891754784 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEIGER | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GEIGER | ||||||||
| OtherFirstName: | SKIP | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | DO | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 2580 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658012580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178294620 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18598 HIGHWAY 13 NORTH | ||||||||
| Address2: | BRANSON WEST | ||||||||
| City: | BRASON WEST | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172728497 | ||||||||
| FaxNumber: | 4172728496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2006 | ||||||||
| LastUpdateDate: | 05/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 108506 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100288780C | 05 | KS | MEDICAID | P00119337 | 01 | RAILROAD MCR WATHEN MEDICAL CENTER | OTHER | 010062129 | 01 | RAILROAD MEDICARE | OTHER | 100288780A | 05 | KS | MEDICAID | 100317800B | 05 | KS | MEDICAID | BG6253760 | 01 | DEA | OTHER | 249797101 | 05 | MO | MEDICAID | 100005790 | 01 | RAILROAD MEDICARE | OTHER |