Provider Demographics
NPI:1053454124
Name:GEISERT, WILLIAM JEFFREY (OD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JEFFREY
Last Name:GEISERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 OLD CHENEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3533
Mailing Address - Country:US
Mailing Address - Phone:402-817-5626
Mailing Address - Fax:402-817-5631
Practice Address - Street 1:6100 O ST
Practice Address - Street 2:BLDG #59
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505
Practice Address - Country:US
Practice Address - Phone:402-467-3423
Practice Address - Fax:402-467-3425
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE944152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE06718OtherBXBS
NE06718OtherBXBS
NE263197GMedicare ID - Type Unspecified