Provider Demographics
NPI:1760599559
Name:JON F GEERS, MD PC
Entity Type:Organization
Organization Name:JON F GEERS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:F
Authorized Official - Last Name:GEERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-934-9191
Mailing Address - Street 1:PO BOX 68952
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-0952
Mailing Address - Country:US
Mailing Address - Phone:317-802-3138
Mailing Address - Fax:317-870-0499
Practice Address - Street 1:188 STATE ROAD 129 S
Practice Address - Street 2:SUITE #A
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7628
Practice Address - Country:US
Practice Address - Phone:812-934-9191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045117208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200892660Medicaid
711160Medicare PIN