Provider Demographics
NPI:1558573576
Name:GEESMAN, JOHN THOMAS (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:GEESMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3377 SARATOGA CT
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-4567
Mailing Address - Country:US
Mailing Address - Phone:641-430-3321
Mailing Address - Fax:
Practice Address - Street 1:1010 4TH ST SW
Practice Address - Street 2:FOREST PARK PHARMACY
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2857
Practice Address - Country:US
Practice Address - Phone:641-422-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist