Provider Demographics
NPI:1346295581
Name:GEIGER, SUSAN M (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:GEIGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:KORMANIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:106 BLANCA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2340
Mailing Address - Country:US
Mailing Address - Phone:719-589-8110
Mailing Address - Fax:719-589-8111
Practice Address - Street 1:2115 STUART AVE
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2269
Practice Address - Country:US
Practice Address - Phone:719-589-8110
Practice Address - Fax:719-589-8111
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44134207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72050268Medicaid
CO840255530055OtherROCKY MTN HEALTH PLANS
CO72050268Medicaid
COC805427Medicare PIN