Provider Demographics
NPI:1508889262
Name:GIESY, BRYAN D (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:D
Last Name:GIESY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7322 KINGSGATE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6566
Mailing Address - Country:US
Mailing Address - Phone:513-755-1355
Mailing Address - Fax:513-755-1357
Practice Address - Street 1:7322 KINGSGATE WAY
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6566
Practice Address - Country:US
Practice Address - Phone:513-755-1355
Practice Address - Fax:513-755-1357
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2964213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2054931Medicaid
OH2700527OtherUNITED HEALTHCARE
OH6064563001OtherCIGNA
OH2021491OtherAETNA
000000016333OtherANTHEM BC/BS
OH0843513Medicare ID - Type Unspecified1402 N HIGH ST
OH2054931Medicaid
000000016333OtherANTHEM BC/BS
OHU69601Medicare UPIN
OH0843517Medicare ID - Type Unspecified1156 COLUMBUS AVE SUITE 2