Provider Demographics
NPI:1871502294
Name:GEIS, DICK ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DICK
Middle Name:ALLEN
Last Name:GEIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7046 NW 74TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66618-5001
Mailing Address - Country:US
Mailing Address - Phone:785-246-0604
Mailing Address - Fax:785-232-8572
Practice Address - Street 1:2200 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3904
Practice Address - Country:US
Practice Address - Phone:785-234-8601
Practice Address - Fax:785-234-2575
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-17234204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSD17384Medicare UPIN