Provider Demographics
NPI:1508052507
Name:WILLIAM D. GIESEKE, MDPA
Entity Type:Organization
Organization Name:WILLIAM D. GIESEKE, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:GIESEKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-499-8025
Mailing Address - Street 1:5130 LINTON BLVD
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6596
Mailing Address - Country:US
Mailing Address - Phone:561-499-8025
Mailing Address - Fax:561-496-7949
Practice Address - Street 1:5130 LINTON BLVD
Practice Address - Street 2:SUITE B-2
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6596
Practice Address - Country:US
Practice Address - Phone:561-499-8025
Practice Address - Fax:561-496-7949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0986OtherMEDICARE GROUP NUMBER