Provider Demographics
NPI:1740608538
Name:GEISLER, THOMAS ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:GEISLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:667 EASTLAND AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4503
Mailing Address - Country:US
Mailing Address - Phone:716-640-4764
Mailing Address - Fax:
Practice Address - Street 1:145 W 23RD ST STE 101
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2858
Practice Address - Country:US
Practice Address - Phone:814-452-2767
Practice Address - Fax:814-459-2976
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012519207R00000X, 207RG0100X
PAOS020445207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
14569725OtherCAQH