Provider Demographics
NPI:1417953035
Name:GEIS, LINDA STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:STANLEY
Last Name:GEIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 VEACH RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-8800
Mailing Address - Country:US
Mailing Address - Phone:270-684-5005
Mailing Address - Fax:
Practice Address - Street 1:2900 VEACH RD
Practice Address - Street 2:SUITE 3
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-8800
Practice Address - Country:US
Practice Address - Phone:270-684-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28195208000000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64281959Medicaid
KYF80627Medicare UPIN
KYK009190Medicare PIN