Provider Demographics
NPI:1285684001
Name:GEISLER, ERIC LANGER (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:LANGER
Last Name:GEISLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SERENITY LANE
Mailing Address - Street 2:
Mailing Address - City:COBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97408
Mailing Address - Country:US
Mailing Address - Phone:541-687-1110
Mailing Address - Fax:541-284-2873
Practice Address - Street 1:1 SERENITY LANE
Practice Address - Street 2:
Practice Address - City:COBURG
Practice Address - State:OR
Practice Address - Zip Code:97408
Practice Address - Country:US
Practice Address - Phone:541-687-1110
Practice Address - Fax:541-284-2873
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18798207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR063446Medicaid
OOOOWFBLYMedicare ID - Type Unspecified
OR063446Medicaid