Provider Demographics
NPI:1841418290
Name:GEILER, THOMAS G (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:GEILER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1000 WILLOW CREEK RD STE J
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1645
Mailing Address - Country:US
Mailing Address - Phone:928-445-2060
Mailing Address - Fax:928-445-2067
Practice Address - Street 1:1000 WILLOW CREEK RD STE J
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1645
Practice Address - Country:US
Practice Address - Phone:928-445-2060
Practice Address - Fax:928-445-2067
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ#308152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z74690Medicare PIN
T41639Medicare UPIN