Provider Demographics
NPI:1558588525
Name:GEERS, JOHANNES ADRIANUS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNES
Middle Name:ADRIANUS
Last Name:GEERS
Suffix:
Gender:M
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:BOX 1359
Mailing Address - Street 2:
Mailing Address - City:COALDALE
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T1M1N3
Mailing Address - Country:CA
Mailing Address - Phone:403-345-5500
Mailing Address - Fax:403-345-5507
Practice Address - Street 1:BOX 1359
Practice Address - Street 2:
Practice Address - City:COALDALE
Practice Address - State:ALBERTA
Practice Address - Zip Code:T1M1N3
Practice Address - Country:CA
Practice Address - Phone:403-345-5500
Practice Address - Fax:403-345-5507
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG44845Medicare UPIN
FL32975Medicare ID - Type Unspecified